Evidence map›Paper›PMID 37691046›Full record

ArticleArchives of orthopaedic and trauma surgery2023

Anatomic repair and ligament bracing as an alternative treatment option for acute combined PCL injuries involving the posteromedial or posterolateral corner-results of a multicentre study.

Tobias J Gensior, Bastian Mester, Andrea Achtnich, Philipp W Winkler, Ralf Henkelmann, Pierre Hepp, Richard Glaab, Matthias Krause, Karl-Heinz Frosch, Johannes Zellner and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Tobias J Gensior *OPND Clinic Neuss-Düsseldorf, Neuss, Germany.
Bastian Mester *Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany. bastian.mester@uk-essen.de.ORCID http://orcid.org/0000-0003-2125-7078
Andrea AchtnichDepartment of Sports Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Philipp W WinklerDepartment of Sports Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Ralf HenkelmannDepartment of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.
Pierre HeppDepartment of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany.
Richard GlaabDepartment of Traumatology, Cantonal Hospital Aarau, Aarau, Switzerland.
Matthias KrauseDepartment of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Karl-Heinz FroschDepartment of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Johannes ZellnerSporthopaedicum Regensburg, Regensburg, Germany.
Christian SchoeppClinic for Arthroscopic Surgery, Sports Traumatology and Sports Medicine, BG Clinic Duisburg, Duisburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCombined PCL injuries involving the posteromedial/-lateral corner (PMC/PLC) usually require surgical management. Literature shows controversy regarding the standards of treatment. Suture-augmented repair leads to excellent results in acute knee dislocations but has not been investigated clinically in combined PCL injuries. The purpose of this multicentre study was to evaluate the clinical outcome of this technique in acute combined PCL injuries. MATERIALS &

methodsN = 33 patients with acute combined PCL injuries involving the PMC/PLC were treated by one-stage suture repair with ligament bracing of the PCL and suture repair of the accompanying PMC/PLC injuries with/without ligament bracing or primary augmentation by semitendinosus autograft. Outcome was assessed by IKDC questionnaire, Lysholm Score, Tegner Activity Scale and KOOS. Additional PCL stress-radiography was performed.

resultsN = 31 patients with combined PCL injuries (female: male = 7:24; age 39.1 ± 13.8 years) with a follow-up of 16.8 ± 9.6 months were finally evaluated. 18 had PMC injuries, 13 PLC injuries. 32.2% presented with accompanying meniscal tears (70% medial meniscus). 19.4% showed cartilage injuries grade III-IV. Complications included one infection and four knee stiffnesses. Three had symptomatic postoperative instability, all affiliated to the PLC group. The IKDC was 69.8 ± 16.5, Lysholm score 85 ± 14.4 and KOOS 89.7 ± 8.1. Median loss of activity (Tegner) was 0.89 ± 1.31. Comparing PMC and PLC, all scores showed a tendency towards more favourable outcomes in the PMC group (n.s.). Stress-radiography showed an overall side-to-side difference of 3.7 ± 3.8 mm. Subgroup evaluation showed statistically significant better results (p = 0.035) of PMC (2.5 ± 1.5 mm) versus PLC (5.8 ± 5.6 mm).

conclusionsOne-stage suture repair with ligament bracing is a viable technique for acute combined PCL injuries and predominantly leads to good and excellent clinical outcomes. Patients with PLC injuries show a tendency towards inferior outcomes and higher instability rates compared to PMC injuries. These results may help in therapy planning and counselling patients with these rare injury pattern. LEVEL OF EVIDENCE: Level II.

Indexed as

Anterior Cruciate Ligament InjuriesJoint InstabilityPosterior Cruciate LigamentAdultAnterior Cruciate LigamentFemaleFollow-Up StudiesHumansKnee JointMaleMiddle AgedTreatment OutcomeAugmented suture repairCombined PCL injuryLigament bracingPosterolateral cornerPosteromedial corner

Identifiers

PMID37691046
PMCPMC10635947

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.