Repair Fails More Frequently Than Reconstruction in Acute Posterolateral Corner Knee Injuries: A Systematic Review of Outcomes Following Surgical Management
Notice bibliographique
Résumé
Purpose To synthesize the current literature on posterolateral corner (PLC) reconstruction and repair, focusing on a comparison of surgical techniques and outcomes based on injury chronicity in the setting of sports‐related ligament tears. Methods A systematic review of the literature, including queries of the PubMed/MEDLINE, Embase, and Cochrane Library databases, was performed in March 2024. Studies were included if they were of Level IV evidence or greater, reported PLC reconstruction or repair outcomes, and had a minimum 2‐year follow‐up. Patient demographics, injury type, time from injury to surgery, surgical technique, subjective patient outcomes, objective physical examination findings, and complications were obtained. Postoperative physical examination findings of varus and posterolateral rotatory stability and reoperation for instability were used to determine surgical success or failure. Means and ranges were recorded for continuous variables. Forest plots were generated for failure rates by subgroup, and an I 2 statistic was used as a measure of heterogeneity. Except for 3 studies, injuries were considered acute when treated within 3 weeks of injury. Quality assessment was conducted using the Newcastle‐Ottawa Scale for cohort studies and the National Institutes of Health Quality Assessment Tool for case series studies. Results Twenty‐nine of the 63 reviewed studies (791 patients) met inclusion criteria. Two of the studies were Level II, 11 Level III, and 16 Level IV evidence. Mean patient age ranged from 19 to 69.1 years. Mean time from injury to surgery ranged from 8.1 to 19 days (acute) and 7.2 weeks to 70.2 months (chronic). Mean postoperative Lysholm scores ranged from 80.8 to 97.0 (acute) and 76.5 to 94.5 (chronic). Mean postoperative International Knee Documentation Committee scores ranged from 59.8 to 87.3 (acute) and 64 to 91.9 (chronic). Within the acute PLC group, 114 (59.3%) patients were treated with isolated repair, and the remaining 78 (40.7%) were treated with reconstruction. Within this group, failure rates, defined by varus stress examination or reoperation, ranged from 0% to 40%. More specifically, reconstruction failure rates ranged from 0% to 15%, whereas repair failure rates ranged from 0% to 40%. All 602 chronic PLC patients were treated with reconstruction, and the failure rate ranged from 0% to 27%, with a single outlier study of 2 patients reporting a 50% failure rate. Conclusions The findings of this review suggest that repair of PLC injuries in the acute setting may fail at higher rates than reconstruction. Additionally, chronic PLC injuries are predominantly treated with reconstruction and experience greater variability in their rates of success compared to acute injuries. Level of Evidence Level IV, systematic review of Level II‐IV studies.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,075 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,008 |
| Bibliométrie | 0,012 | 0,013 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».