HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 34/9/1419    most recent 0363546506287743v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Noyes, F. R. Articles by Albright, J. C. Search for Related Content PubMed PubMed Citation Articles by Noyes, F. R. Articles by Albright, J. C. Related Collections Reconstruction Knee

An Analysis of the Causes of Failure in 57 Consecutive Posterolateral Operative Procedures

Frank R. Noyes, MD^*, Sue D. Barber-Westin^*, and Jay C. Albright, MD

From the ^* Cincinnati Sportsmedicine Research and Education Foundation, Cincinnati, Ohio, and the Orlando Regional Hospital, Orlando, Florida

Address correspondence to Sue D. Barber-Westin, Cincinnati Sportsmedicine Research and Education Foundation, 10663 Montgomery Rd, Cincinnati, OH 45242 (e-mail: sbwestin{at}csmref.org).

Purpose: To investigate 57 failed posterolateral procedures in 30 consecutive knees to determine factors that may have contributed to the failure.

Study Design: Case series; Level of evidence, 4.

Methods: Thirty patient records were reviewed by an independent surgeon. The index posterolateral operations were done for 13 acute and 17 chronic knee injuries. The anterior cruciate ligament was ruptured in 17 knees, the posterior cruciate ligament was torn in 5 knees, and both cruciates were ruptured in 8 knees. In 25 knees, 46 revision posterolateral procedures had been performed, of which 27 had also failed (in 21 knees). Five knees did not undergo revision of the posterolateral structures.

Results: In 22 knees, multiple factors were identified that most likely contributed to the failure of the posterolateral procedures. The most common factors were nonanatomical graft reconstruction (23 knees), untreated varus malalignment (10 knees), and failure to successfully reconstruct all ruptured knee ligaments, including cruciates (27 knees). Thirty-nine anterior cruciate ligament procedures were done in 24 knees, including 24 primary and 15 revision operations. Seventeen posterior cruciate ligament procedures were done in 13 knees, including 13 primary and 4 revision operations. At the time of writing, 16 of 24 knees had a functional anterior cruciate ligament graft and 5 of 13 had a functional posterior cruciate ligament graft.

Conclusion: The results suggest greater emphasis during the index operation for anatomical graft reconstruction of one or more of the posterolateral structures as necessary, restoration of all ruptured cruciate ligaments, and correction of varus malalignment.

Key Words: posterolateral • ligament failure • varus malalignment

This article has been cited by other articles:

				A. Ranawat, C. L. Baker III, S. Henry, and C. D. Harner Posterolateral Corner Injury of the Knee: Evaluation and Management J. Am. Acad. Ortho. Surg., September 1, 2008; 16(9): 506 - 518. [Abstract] [Full Text] [PDF]

				B. R. Coobs, R. F. LaPrade, C. J. Griffith, and B. J. Nelson Biomechanical Analysis of an Isolated Fibular (Lateral) Collateral Ligament Reconstruction Using an Autogenous Semitendinosus Graft Am. J. Sports Med., September 1, 2007; 35(9): 1521 - 1527. [Abstract] [Full Text] [PDF]

				F. R. Noyes and S. D. Barber-Westin Posterolateral Knee Reconstruction With an Anatomical Bone-Patellar Tendon-Bone Reconstruction of the Fibular Collateral Ligament Am. J. Sports Med., February 1, 2007; 35(2): 259 - 273. [Abstract] [Full Text] [PDF]