Abstract：
Injuries to the posterolateral corner (PLC) of the knee are often overlooked but, require reconstruction in order to restore stability in varus and external rotation. Among the many anatomic and non-anatomic PLC reconstruction techniques available, the modified Larson (mLR), LaPrade (LPR) and Versailles reconstruction (VR) procedures are widely used.
The hypothesis was that anatomic PLC reconstruction (VR and LPR procedures) provides better restoration and control of external rotation.
Fifteen fresh-frozen cadaveric knees were tested to compare the 3 procedures. Varus laxity on stress radiographs in full knee extension and external rotatory laxity on dial test at 30° flexion were quantified at 3 phases: intact knee, PLC sectioned and PLC reconstructed.
Mean varus laxity did not differ significantly between techniques in intact knees (p=.14), after PLC sectioning (p=.14) or after PLC reconstruction (p=.17). After PLC reconstruction, varus laxity was restored, with no statistical difference between mLR, VR and LPR compared to intact test values (respectively, -1.0, -1.3 and -1.5; p=.98). In all 3 groups, mean external rotation laxity on dial test at 30° flexion did not significantly differ between intact knees (p=.32) and after PLC sectioning (p=.15). After PLC reconstruction, the mLR technique was significantly less effective in restoring rotational stability than the VR and LPR techniques (p=.025).
The VR technique provided similar outcomes to LPR for restoring stability in varus and external rotation. The 2 \"anatomic\" reconstruction procedures (VR and LPR) were significantly more effective than the modified Larson technique for external rotation control, confirming the study hypothesis. Consequently, it remains preferable to use anatomic techniques in multiligament injuries involving the PLC.
IV, cadaver study.
The hypothesis was that anatomic PLC reconstruction (VR and LPR procedures) provides better restoration and control of external rotation.
Fifteen fresh-frozen cadaveric knees were tested to compare the 3 procedures. Varus laxity on stress radiographs in full knee extension and external rotatory laxity on dial test at 30° flexion were quantified at 3 phases: intact knee, PLC sectioned and PLC reconstructed.
Mean varus laxity did not differ significantly between techniques in intact knees (p=.14), after PLC sectioning (p=.14) or after PLC reconstruction (p=.17). After PLC reconstruction, varus laxity was restored, with no statistical difference between mLR, VR and LPR compared to intact test values (respectively, -1.0, -1.3 and -1.5; p=.98). In all 3 groups, mean external rotation laxity on dial test at 30° flexion did not significantly differ between intact knees (p=.32) and after PLC sectioning (p=.15). After PLC reconstruction, the mLR technique was significantly less effective in restoring rotational stability than the VR and LPR techniques (p=.025).
The VR technique provided similar outcomes to LPR for restoring stability in varus and external rotation. The 2 \"anatomic\" reconstruction procedures (VR and LPR) were significantly more effective than the modified Larson technique for external rotation control, confirming the study hypothesis. Consequently, it remains preferable to use anatomic techniques in multiligament injuries involving the PLC.
IV, cadaver study.
摘要：
膝关节后外侧角（PLC）的损伤经常被忽视，但是，需要重建，以恢复内翻和外部旋转的稳定性。在许多可用的解剖和非解剖PLC重建技术中，修改后的拉尔森（mLR），LaPrade（LPR）和凡尔赛重建（VR）程序被广泛使用。
假设是解剖PLC重建（VR和LPR程序）可以更好地恢复和控制外部旋转。
测试了15个新鲜冷冻的尸体膝盖，以比较3个程序。在3个阶段对完全膝盖伸展的应力X线片上的内翻松弛和30°屈曲时的表盘测试上的外部旋转松弛进行了量化：完整的膝盖，PLC分段和PLC重构。
在完整的膝盖中，平均内翻松弛度在技术之间没有显着差异（p=.14），PLC切片后(p=.14)或PLC重建后(p=.17)。PLC改造后,内翻松弛恢复了，mLR之间没有统计学差异，VR和LPR与完整测试值(分别，-1.0、-1.3和-1.5；p=.98）。在所有三组中，在30°屈曲时的表盘测试中，平均外部旋转松弛度在完整的膝盖（p=.32）和PLC切片后（p=.15）之间没有显着差异。PLC改造后,mLR技术在恢复旋转稳定性方面的效果明显不如VR和LPR技术(p=.025).
VR技术在恢复内翻和外部旋转的稳定性方面提供了与LPR相似的结果。2个“解剖”重建程序（VR和LPR）比改良的Larson技术对外部旋转控制显着更有效，证实了研究假设。因此,在涉及PLC的多韧带损伤中使用解剖技术仍然是优选的。
IV,尸体研究。
假设是解剖PLC重建（VR和LPR程序）可以更好地恢复和控制外部旋转。
测试了15个新鲜冷冻的尸体膝盖，以比较3个程序。在3个阶段对完全膝盖伸展的应力X线片上的内翻松弛和30°屈曲时的表盘测试上的外部旋转松弛进行了量化：完整的膝盖，PLC分段和PLC重构。
在完整的膝盖中，平均内翻松弛度在技术之间没有显着差异（p=.14），PLC切片后(p=.14)或PLC重建后(p=.17)。PLC改造后,内翻松弛恢复了，mLR之间没有统计学差异，VR和LPR与完整测试值(分别，-1.0、-1.3和-1.5；p=.98）。在所有三组中，在30°屈曲时的表盘测试中，平均外部旋转松弛度在完整的膝盖（p=.32）和PLC切片后（p=.15）之间没有显着差异。PLC改造后,mLR技术在恢复旋转稳定性方面的效果明显不如VR和LPR技术(p=.025).
VR技术在恢复内翻和外部旋转的稳定性方面提供了与LPR相似的结果。2个“解剖”重建程序（VR和LPR）比改良的Larson技术对外部旋转控制显着更有效，证实了研究假设。因此,在涉及PLC的多韧带损伤中使用解剖技术仍然是优选的。
IV,尸体研究。
