Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees

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.

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Funding

No funding was received for this study.

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Correspondence to Alexander Otto.

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Conflict of interest

A.B. Imhoff reports personal fees outside the submitted work from Arthrex, Naples, FL, USA, personal fees from Medi, Bayreuth, GER, and personal fees from Arthrosurface, Franklin, MA, USA. The remaining authors declare that they have no conflict of interest.

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This study has been approved by the institutional review board of the Technical University of Munich, Germany (IRB no. 455/16 S).

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Otto, A., Helal, A., Imhoff, F.B. et al. Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees. Knee Surg Sports Traumatol Arthrosc 28, 2543–2550 (2020). https://doi.org/10.1007/s00167-020-05852-6

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Keywords

  • Internal bracing
  • Multi-ligament injuries
  • Knee dislocation
  • PCL bracing
  • Posterior cruciate ligament
  • Acute PCL lesion