Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions

Tardy, Nicolas; Boisrenoult, Philippe; Teissier, Philippe; Steltzlen, Camille; Beaufils, Philippe; Pujol, Nicolas

doi:10.1007/s00167-016-4067-4

Cited by 48 publications

(34 citation statements)

References 53 publications

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“…1. Sixteen studies [14,16,23,25,[37][38][39][40][41][42][43][44][45][46][47][48] on single ACL injury (3004 patients) and 14 studies on MLKI [30,32,33,[49][50][51][52][53][54][55][56][57][58][59] (545 patients) were included in this meta-analysis of early vs delayed surgery. Details of these included studies are presented in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The number of total meniscus injuries according to early vs delayed surgery was determined in 13 studies (2064 patients) on single ACL injury [23, 25, 37-44, 46, 47] and 4 studies (185 patients) on MLKI [49,[56][57][58]. The overall risk of meniscus tear in the delayed surgery group was significantly higher than that in the early surgery group, but this showed substantial heterogeneity (OR 1.73 [95% CI 1.1-2.73], p = 0.01; I 2 = 78%, p < 0.01), as did the L'Abbé plot (Fig.…”

Section: Risk Of Concomitant Meniscus Tearmentioning

confidence: 99%

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A systematic review comparing the results of early vs delayed ligament surgeries in single anterior cruciate ligament and multiligament knee injuries

Kim

Han

Park

et al. 2021

Knee Surg & Relat Res

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Purpose The purpose of this study was to compare clinical outcomes and incidence of concomitant injuries in patients undergoing early vs delayed surgical treatment of single anterior cruciate ligament (ACL) injury and multiligament knee injury (MLKI). Methods A literature search using PubMed, Embase, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, and Scopus from their inception to April 30, 2020 was conducted. Studies with levels I to IV evidence reporting the incidence of meniscus or cartilage injury according to early vs delayed surgery in single ACL injuries and MLKIs were included. In the meta-analysis, data based on the number of meniscus and cartilage injuries were extracted and pooled. Lysholm and Tegner scores were analyzed using two-sample Z-tests to calculate the non-weighted mean difference (NMD). A meta-regression analysis was also performed to determine the effect of single ACL injury and MLKI/study design. Results Sixteen studies on single ACL injury and 14 studies on MLKI were included in this analysis. In the analysis, there were significant decreases in Lysholm score (NMD − 5.3 [95% confidence interval (CI) − 7.37 to − 3.23]) and Tegner score (NMD − 0.25 [95% CI − 0.45 to − 0.05]) and increases in risk of meniscus tear (odds ratio [OR] 1.73 [95% CI 1.1–2.73], p = 0.01) and cartilage injury (OR 2.48 [95% CI 1.46–4.2], p = 0.0007) in the delayed surgery group regardless of single ACL injury or MLKI. The result of the meta-regression analysis indicated that single ACL injury and MLKI/study design were not significant moderators of overall heterogeneity (p > 0.05). Conclusions Our study suggests that delayed ACL surgery significantly resulted in a higher risk of meniscus tear and cartilage injury and decreased Lysholm and Tegner scores compared to early ACL surgery. The Lysholm scores in the delayed MLKI surgery group were significantly decreased, but the risks of meniscus tear and cartilage injury in the delayed MLKI surgery group remained unclear. Level of evidence Level III, meta-analysis.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Concomitant Meniscus Tearmentioning

confidence: 99%

A systematic review comparing the results of early vs delayed ligament surgeries in single anterior cruciate ligament and multiligament knee injuries

Kim

Han

Park

et al. 2021

Knee Surg & Relat Res

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“…Similarly, early PLC reconstruction (<3 weeks postinjury) had better results (72%) than those who underwent reconstruction thereafter (44%). 47 On average, 66%–79% patients KDIIIM injuries obtained good to excellent outcomes as compared to 44%–57% in case of KDIIIL injuries.…”

Section: Discussionmentioning

confidence: 95%

Knee Dislocations in Sports Injuries

Pardiwala

Rao

Anand

et al. 2017

IJOO

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Knee dislocations are devastating when they occur on the athletic field or secondary to motor sports. The complexity of presentation and spectrum of treatment options makes these injuries unique and extremely challenging to even the most experienced knee surgeons. An astute appreciation of the treatment algorithm is essential to plan individualized management since no two complex knee dislocations are ever the same. Moreover, attention to detail and finesse of surgical technique are required to obtain a good functional result and ensure return to play. Over the past 10 years, our service has treated 43 competitive sportsmen with knee dislocations, and this experience forms the basis for this narrative review.

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“…As with our material, some previous studies have reported good or excellent outcomes following multiligament injuries. 8,9,28 This finding is in part difficult to explain. Regarding the effect of cartilage and meniscal lesions, it has previously been shown that the patient-reported outcome for ACL injuries with concomitant meniscal lesions and superficial cartilage lesions is equal to that without such lesions.…”

Section: Discussionmentioning

confidence: 96%

Effect of Activity at Time of Injury and Concomitant Ligament Injuries on Patient-Reported Outcome After Posterior Cruciate Ligament Reconstruction

Owesen

Røtterud

Engebretsen

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The outcomes after posterior cruciate ligament reconstruction (PCLR) have been shown to be inferior to those of anterior cruciate ligament reconstruction. There is a lack of knowledge regarding prognostic factors of PCLR outcomes.Purpose:To explore the effect of injury mechanism and concomitant ligament injuries on patient-reported outcomes at 2-year follow-up after PCLR.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 373 patients who underwent primary PCLR and who were registered in the Norwegian Knee Ligament Registry were included. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as the patient-reported outcome measure. At 2-year follow-up, 252 patients (68%) had completed the KOOS. Multiple regression analysis was used to evaluate the effects of injury activity and multiligament injuries on the KOOS outcomes.Results:In the adjusted and unadjusted regression analyses, patients injured during sports reported significantly better outcome at 2-year follow-up after PCLR than patients injured during other activities (P < .001) according to all KOOS subscales. Adjusted analysis was as follows for the KOOS subscales: Symptoms (regression coefficient [β], 7.0; 95% CI, 1.9-12.2), Pain (β, 13.4; 95% CI, 8.0-18.9), Activities of Daily Living (β, 12.6; 95% CI, 7.1-18.1), Sport/Recreation (β, 15.3; 95% CI, 8.0-22.5), and Quality of Life (β, 13.5; 95% CI, 7.1-20.0). In the unadjusted analysis, patients with isolated PCL injuries reported higher scores in the Sport/Recreation subscale (β, –7.9; 95% CI, –15.5 to –0.3). The difference was not significant in the adjusted analysis. No other significant differences in KOOS outcomes were found between isolated and multiligament injuries.Conclusion:Patients injured in sports reported better outcomes at 2 years after PCLR as compared with patients injured in other activities. Multiligament injuries involving the PCL do not seem to predict a worse outcome than for isolated PCL injuries.

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Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions

Abstract: IV.

Cited by 48 publications

References 53 publications

A systematic review comparing the results of early vs delayed ligament surgeries in single anterior cruciate ligament and multiligament knee injuries

A systematic review comparing the results of early vs delayed ligament surgeries in single anterior cruciate ligament and multiligament knee injuries

Knee Dislocations in Sports Injuries

Effect of Activity at Time of Injury and Concomitant Ligament Injuries on Patient-Reported Outcome After Posterior Cruciate Ligament Reconstruction

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