DOI: https://doi.org/10.15674/0030-59872018492-101
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The results of treatment of combined injuries of the posterior cruciate ligament and structures of the posterior lateral corner of the knee joint

Maksim Golovakha, Inna Didenko, Sergiy Krasnoperov, Weniamin Orljanski

Abstract


Insufficient attention to the structures of posterolateral knee corner in case of PCL injury can lead to unsatisfactory results. Objective: to improve the results of treatment patients with
posterior cruciate ligament injury by determining the indications for restoration of posterolateral knee corner structures. Methods: there were 68 patients without clear signs of rotation instability by Dial and Varus stress tests. But in all cases we observed asymmetry of these tests compare to contralateral leg. Patients were divided into two groups, homogeneous by gender and age: the main group (36 patients, 52.94 %) — restoration
of the PCL and the posterolateral structures, comparison group (32 patients, 47.06 %) — only PCL restoration. The results of treatment were evaluated with VAS and IKDS scales.
Results: а subjective assessment of patient’s satisfaction was obtained from 36 (100.00 %) patients in the main group and 30 from the comparison group (93.75 %). It was found out that 25 (37.88 %) patients were very satisfied with the early outcome of treatment (6 weeks), 34 (51.52 %) — satisfied, 5 (7.58 %) — partially satisfied, 2 (3.03 %) — not satisfied. Long-term followup results were assessed in 31 (86.11 %) patients of the main
group, 24 (75 %) — of comparison group. 30 (96.78 %) patients of the main group and 21 (91.3 %) of comparison group would agree to repeat surgery again. According to the subjective IKDC scale excellent and good results of treatment were found in 87.5 % of the main group, and only 47.37 % in the comparison group; unsatisfactory — at 4.15 and 15.79 % respectively. Conclusions: in all patients with PCL injury who had minor signs of rotational instability, restoration of the PCL and posterolateral structures allowed to get higher rate of excellent and good results after treatment. In patients with PCL injury and asymmetry
of external rotation test, it is necessary to reconstruct the PCL and structures of osterolateral corner. 


Keywords


knee joint; arthroscopy; posterolateral instability

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