Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament le
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Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees Alexander Otto1,2 · Ahmed Helal1 · Florian B. Imhoff1 · Julian Mehl1 · Elmar Herbst1 · Andrea E. Achtnich1 · Philipp Forkel1 · Andreas B. Imhoff1 · Andreas Schmitt1 Received: 12 March 2019 / Accepted: 10 January 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The purpose of this study was to evaluate the clinical and radiological outcomes of acute posterior cruciate ligament (PCL) lesions in multiple injured knees that were surgically treated with internal bracing. Methods Acute complete PCL lesions in multiple injured knees with subsequent internal-bracing treatment within 21 days between 2014 and 2016 were eligible for inclusion. At final follow-up, patients were assessed with Tegner, Lysholm, and IKDC scores. PCL stability and healing were verified with KT-2000, stress radiography and magnetic resonance imaging (MRI). Results Fourteen patients [mean age 37.4 (± 17.8; SD) years] were evaluated after a mean follow-up of 19.9 (± 7.7; SD) months. Thirteen patients suffered complete lesions of the PCL with concomitant ligamentous injuries (Schenck I: six cases, Schenck III M: five cases, Schenck IV N: one case, Schenck V: one case). Median Tegner, mean Lysholm and mean IKDC scores at follow-up were 4 (2–7; interquartile range), 69.1 (± 16.6; SD) and 68.9 (± 18.1; SD) respectively. Posterior translation averaged 5.8 (± 2.2; SD) mm with the KT 2000 and stress radiography showed a mean posterior tibial translation of 5.5 (± 4.1; SD) mm in the side to side comparison. MRI showed adequate PCL healing. Conclusions Internal bracing as treatment for acute PCL ruptures in multiple injured knees showed adequate restoration of posterior tibial translation in a single-centre study including 14 cases. Level of evidence IV. Keywords Internal bracing · Multi-ligament injuries · Knee dislocation · PCL bracing · Posterior cruciate ligament · Acute PCL lesion
Introduction Acute injuries of the posterior cruciate ligament (PCL) are rare but severe lesions, affecting 3% of all injured knees [36]. High-grade PCL injuries with concomitant injuries of A. Otto and A. Helal contributed equally. * Alexander Otto [email protected] 1
Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Department of Trauma, Orthopaedic, Plastic and Hand Surgery, University Hospital of Augsburg, Augsburg, Germany
2
the anterior cruciate ligament (ACL), the medial collateral ligament (MCL) or the posterolateral corner (PLC) constitute up to 79% of cases [36]. A combined rupture of multiple ligaments leads to the loss of the continuity of tibiofemoral articulation and is defined as a knee dislocation [31]. Injury mechanisms of knee dislocations include high-energy trauma with abrupt posterior translation of the proximal tibia, hyperflexion or hyperextension in athletes
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