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Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review
PURPOSE: The objective of this systematic literature review was to report the results and complications of recent remnant preservation techniques in posterior cruciate ligament (PCL) reconstruction. METHODS: A systematic review was conducted based on the Preferred Reporting Items for Systematic Revi...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183434/ https://www.ncbi.nlm.nih.gov/pubmed/36208342 http://dx.doi.org/10.1007/s00167-022-07192-z |
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author | D’Ambrosi, Riccardo Hallé, Aurélien Hardy, Alexandre |
author_facet | D’Ambrosi, Riccardo Hallé, Aurélien Hardy, Alexandre |
author_sort | D’Ambrosi, Riccardo |
collection | PubMed |
description | PURPOSE: The objective of this systematic literature review was to report the results and complications of recent remnant preservation techniques in posterior cruciate ligament (PCL) reconstruction. METHODS: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers searched the PubMed, Scopus, Embase, and Cochrane Library databases using the terms “posterior cruciate ligament” or “PCL” and “remnant preserving.” The outcome measures extracted from the studies were the Lysholm score, the International Knee Documentation Committee’s (IKDC) subjective and objective scores, Tegner scores, Orthopädische Arbeitsgruppe Knie (OAK) rate of return to sports, and rate of complications. Data were also extracted from studies that used stress radiographs to perform a quantitative assessment of the preoperative and postoperative anteroposterior stability. RESULTS: The systematic review included 13 studies. The patient cohort of consisted of 643 participants (544 [84.6%] men and 99 [15.4%] women) with a mean age of 32.9 ± 4.0 years. The mean postoperative follow-up was 34.5 ± 10.9 months (range: 24–96 months), while the mean time from injury to surgery was 14.4 ± 9.9 months (range: 0–240 months). All studies reported clinically significant improvement at final follow-up, as evident from the measured subjective and objective IKDC scores, Lysholm score, Tegner score, and OAK rate. Only three studies reported return to sports activity, with a mean percentage of 90.8% (99/109). All studies showed a significant improvement in posterior translation, from 11.5 ± 1.2 mm to 3.3 ± 1.1 mm, using radiography (side-to-side difference). This systematic review revealed 13 (2.0%) failures and 33 (5.1%) minor complications: 10 (1.6%) cases of stiffness, 21 (4.9%) screws removal, 1 (0.2%) injury of the peroneal nerve, and 1 (0.2%) fibular fracture. CONCLUSIONS: With the currently available data, all studies included in the review on posterior cruciate ligament reconstruction with remnant preservation demonstrated satisfactory outcomes at mid-term follow-up (> 24 months), despite varying surgical techniques and graft types, and intervals from injury to surgery. For clinical relevance, standard PCL reconstruction is a highly effective operation in terms of improvement in functional status, knee stability, quality of life, and cost effectiveness. The remnant preservation technique requires more comprehensive diagnostic assessments of the PCL remnant patterns and more complicated surgical procedures. Given the absence so far of high quality studies with long-term follow-up, the remnant-preserving techniques should be recommended only by experienced knee arthroscopic surgeons. LEVEL OF EVIDENCE: Level IV. STUDY REGISTRATION: reviewregistry1376—www.researchregistry.com. |
format | Online Article Text |
id | pubmed-10183434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-101834342023-05-16 Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review D’Ambrosi, Riccardo Hallé, Aurélien Hardy, Alexandre Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: The objective of this systematic literature review was to report the results and complications of recent remnant preservation techniques in posterior cruciate ligament (PCL) reconstruction. METHODS: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers searched the PubMed, Scopus, Embase, and Cochrane Library databases using the terms “posterior cruciate ligament” or “PCL” and “remnant preserving.” The outcome measures extracted from the studies were the Lysholm score, the International Knee Documentation Committee’s (IKDC) subjective and objective scores, Tegner scores, Orthopädische Arbeitsgruppe Knie (OAK) rate of return to sports, and rate of complications. Data were also extracted from studies that used stress radiographs to perform a quantitative assessment of the preoperative and postoperative anteroposterior stability. RESULTS: The systematic review included 13 studies. The patient cohort of consisted of 643 participants (544 [84.6%] men and 99 [15.4%] women) with a mean age of 32.9 ± 4.0 years. The mean postoperative follow-up was 34.5 ± 10.9 months (range: 24–96 months), while the mean time from injury to surgery was 14.4 ± 9.9 months (range: 0–240 months). All studies reported clinically significant improvement at final follow-up, as evident from the measured subjective and objective IKDC scores, Lysholm score, Tegner score, and OAK rate. Only three studies reported return to sports activity, with a mean percentage of 90.8% (99/109). All studies showed a significant improvement in posterior translation, from 11.5 ± 1.2 mm to 3.3 ± 1.1 mm, using radiography (side-to-side difference). This systematic review revealed 13 (2.0%) failures and 33 (5.1%) minor complications: 10 (1.6%) cases of stiffness, 21 (4.9%) screws removal, 1 (0.2%) injury of the peroneal nerve, and 1 (0.2%) fibular fracture. CONCLUSIONS: With the currently available data, all studies included in the review on posterior cruciate ligament reconstruction with remnant preservation demonstrated satisfactory outcomes at mid-term follow-up (> 24 months), despite varying surgical techniques and graft types, and intervals from injury to surgery. For clinical relevance, standard PCL reconstruction is a highly effective operation in terms of improvement in functional status, knee stability, quality of life, and cost effectiveness. The remnant preservation technique requires more comprehensive diagnostic assessments of the PCL remnant patterns and more complicated surgical procedures. Given the absence so far of high quality studies with long-term follow-up, the remnant-preserving techniques should be recommended only by experienced knee arthroscopic surgeons. LEVEL OF EVIDENCE: Level IV. STUDY REGISTRATION: reviewregistry1376—www.researchregistry.com. Springer Berlin Heidelberg 2022-10-08 2023 /pmc/articles/PMC10183434/ /pubmed/36208342 http://dx.doi.org/10.1007/s00167-022-07192-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Knee D’Ambrosi, Riccardo Hallé, Aurélien Hardy, Alexandre Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title | Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title_full | Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title_fullStr | Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title_full_unstemmed | Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title_short | Good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
title_sort | good clinical and radiological results following remnant-preserving posterior cruciate ligament reconstruction: a systematic review |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183434/ https://www.ncbi.nlm.nih.gov/pubmed/36208342 http://dx.doi.org/10.1007/s00167-022-07192-z |
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