Cargando…

Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review

BACKGROUND: In cases of multiple ligaments or medial collateral ligament (MCL) reconstruction, restoring the native anatomy of the posterior oblique ligament (POL) to address chronic valgus instability has been attracting increased attention. PURPOSE: To review the current literature on postoperativ...

Descripción completa

Detalles Bibliográficos
Autores principales: D’Ambrosi, Riccardo, Corona, Katia, Guerra, Germano, Cerciello, Simone, Ursino, Nicola, Cavaignac, Etienne, Vieira, Thais D., Sonnery-Cottet, Bertrand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649099/
https://www.ncbi.nlm.nih.gov/pubmed/34888393
http://dx.doi.org/10.1177/23259671211056070
_version_ 1784610923248353280
author D’Ambrosi, Riccardo
Corona, Katia
Guerra, Germano
Cerciello, Simone
Ursino, Nicola
Cavaignac, Etienne
Vieira, Thais D.
Sonnery-Cottet, Bertrand
author_facet D’Ambrosi, Riccardo
Corona, Katia
Guerra, Germano
Cerciello, Simone
Ursino, Nicola
Cavaignac, Etienne
Vieira, Thais D.
Sonnery-Cottet, Bertrand
author_sort D’Ambrosi, Riccardo
collection PubMed
description BACKGROUND: In cases of multiple ligaments or medial collateral ligament (MCL) reconstruction, restoring the native anatomy of the posterior oblique ligament (POL) to address chronic valgus instability has been attracting increased attention. PURPOSE: To review the current literature on postoperative outcomes, complications, and return to sports after superficial MCL-POL (sMCL-POL) reconstruction to restore medial knee integrity. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two independent reviewers searched the PubMed, Scopus, Embase, and Cochrane Library databases using the terms “posterior oblique ligament,” “posteromedial corner of the knee,” and “reconstruction.” Included were studies that reported postoperative clinical and functional outcomes in patients who had undergone a combined sMCL-POL reconstruction for medial knee instability. The authors evaluated surgical technique, rehabilitation protocol, postoperative outcomes (Lysholm, International Knee Documentation Committee [IKDC], and Tegner scores and valgus stress radiograph), and return to sports and complication rates across the included studies. RESULTS: A total of 6 studies were reviewed. The cohort consisted of 199 patients (121 men and 78 women), with a mean age of 32.7 ± 3.9 years (range, 27.4-36.6 years). The Lysholm and IKDC scores improved from pre- to postoperatively (Lysholm, from 67.2 ± 20.4 to 89.4 ± 3; IKDC, from 45.8 ± 2.1 to 84.8 ± 7.5). The Tegner score produced satisfactory results, from a preoperative mean of 3.3 ± 2.4 to 6.3 ± 0.9 postoperatively. The medial joint opening on valgus stress radiographs ranged from 7.5 ± 1.1 mm preoperatively to 3 ± 3.1 mm postoperatively. After passing activity-specific functional and clinical tests, 88% to 91.3% of the patients were reported to have returned to recreational sports within 6 to 12 months postoperatively, whereas 10% of the patients developed postoperative complications. CONCLUSION: Satisfactory clinical and functional outcomes, a high rate of return to recreational sports, and a low rate of postoperative complications were reported after an sMCL-POL reconstruction to restore medial knee integrity.
format Online
Article
Text
id pubmed-8649099
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-86490992021-12-08 Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review D’Ambrosi, Riccardo Corona, Katia Guerra, Germano Cerciello, Simone Ursino, Nicola Cavaignac, Etienne Vieira, Thais D. Sonnery-Cottet, Bertrand Orthop J Sports Med Article BACKGROUND: In cases of multiple ligaments or medial collateral ligament (MCL) reconstruction, restoring the native anatomy of the posterior oblique ligament (POL) to address chronic valgus instability has been attracting increased attention. PURPOSE: To review the current literature on postoperative outcomes, complications, and return to sports after superficial MCL-POL (sMCL-POL) reconstruction to restore medial knee integrity. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two independent reviewers searched the PubMed, Scopus, Embase, and Cochrane Library databases using the terms “posterior oblique ligament,” “posteromedial corner of the knee,” and “reconstruction.” Included were studies that reported postoperative clinical and functional outcomes in patients who had undergone a combined sMCL-POL reconstruction for medial knee instability. The authors evaluated surgical technique, rehabilitation protocol, postoperative outcomes (Lysholm, International Knee Documentation Committee [IKDC], and Tegner scores and valgus stress radiograph), and return to sports and complication rates across the included studies. RESULTS: A total of 6 studies were reviewed. The cohort consisted of 199 patients (121 men and 78 women), with a mean age of 32.7 ± 3.9 years (range, 27.4-36.6 years). The Lysholm and IKDC scores improved from pre- to postoperatively (Lysholm, from 67.2 ± 20.4 to 89.4 ± 3; IKDC, from 45.8 ± 2.1 to 84.8 ± 7.5). The Tegner score produced satisfactory results, from a preoperative mean of 3.3 ± 2.4 to 6.3 ± 0.9 postoperatively. The medial joint opening on valgus stress radiographs ranged from 7.5 ± 1.1 mm preoperatively to 3 ± 3.1 mm postoperatively. After passing activity-specific functional and clinical tests, 88% to 91.3% of the patients were reported to have returned to recreational sports within 6 to 12 months postoperatively, whereas 10% of the patients developed postoperative complications. CONCLUSION: Satisfactory clinical and functional outcomes, a high rate of return to recreational sports, and a low rate of postoperative complications were reported after an sMCL-POL reconstruction to restore medial knee integrity. SAGE Publications 2021-11-29 /pmc/articles/PMC8649099/ /pubmed/34888393 http://dx.doi.org/10.1177/23259671211056070 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
D’Ambrosi, Riccardo
Corona, Katia
Guerra, Germano
Cerciello, Simone
Ursino, Nicola
Cavaignac, Etienne
Vieira, Thais D.
Sonnery-Cottet, Bertrand
Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title_full Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title_fullStr Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title_full_unstemmed Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title_short Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review
title_sort midterm outcomes, complications, and return to sports after medial collateral ligament and posterior oblique ligament reconstruction for medial knee instability: a systematic review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649099/
https://www.ncbi.nlm.nih.gov/pubmed/34888393
http://dx.doi.org/10.1177/23259671211056070
work_keys_str_mv AT dambrosiriccardo midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT coronakatia midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT guerragermano midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT cerciellosimone midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT ursinonicola midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT cavaignacetienne midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT vieirathaisd midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview
AT sonnerycottetbertrand midtermoutcomescomplicationsandreturntosportsaftermedialcollateralligamentandposteriorobliqueligamentreconstructionformedialkneeinstabilityasystematicreview