Posterolateral knee repair versus reconstruction

Objectives: Our goal was to compare clinical, functional and radiographic outcomes of posterolateral knee injuries treated with repair versus reconstruction. In addition, we compared varus stress radiographs of these patients with controls. Methods: A retrospective chart review was performed to identify patients that underwent posterolateral knee reconstruction or repair from January 1, 2000 to March 1, 2012. Patients were asked to return for a clinical exam and varus stress radiographs, as well as fill out IKDC and Lysholm knee scales. Patients that could not return to clinic were assessed via phone interviews. Chart reviews were performed on patients that could not be contacted.Further, we compared varus stress radiographs of 20 control knees, with no history of knee trauma, to both posterolateral knee repair and reconstruction groups. Results: We identified 61 knees in 60 patients who underwent posterolateral knee reconstruction or repair. 26 knees in 25 patients (17 reconstructions and 9 repairs) were evaluated at mean of 41.86 months postoperatively (range: 6-108). Average IKDC scores for reconstruction and repair were 68.23 and 71.30, respectively. Average Lysholm scores for these groups were 83.11 for reconstructions and 83.30 for repairs. There were no statistically significant differences in IKDC or Lysholm scores between the repair and reconstruction groups. Average varus gapping with the knee at zero degrees was 8.21 and 8.84 millimeters (mm) for reconstructions and repairs, respectively. Average varus gapping at 20 degrees knee flexion was 11.25 mm for reconstructions and 10.34 mm for repairs. No statistically significant differences were observed in varus gapping between the two groups. Control knee measurements, 20 knees in 20 different controls, showed average varus gapping of 5.27 mm at zero degrees and 6.55 mm at 20 degrees knee flexion. There was a statistically significant difference in varus gapping when comparing the operatively treated knees to the control group. On review of all 61 knees, there were five failures: three failed reconstructions, two failed repairs. The other complication included one small wound dehiscence in the reconstruction group that resolved without intervention. Conclusion: Unlike previous studies, we did not find statistical differences in our posterolateral knee patients treated with reconstruction versus repair. We did find statistically significant differences in varus gapping, at both 0 and 20 degrees of knee flexion, between control knees and the operatively treated groups. However, this did not correlate to poor clinical outcomes in either group.

Duke Scholars

Author Annunziato Amendola Orthopaedic Surgery