Abstract：
OBJECTIVE: To review and update the literature regarding outcomes following surgical management of chronic, grade III posterolateral corner (PLC) injuries, with an emphasis on estimating failure rates based upon objective parameters in light of the 2019 expert consensus, while secondarily comparing the failure rates of anatomic versus non-anatomic reconstruction techniques.
METHODS: A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping.
RESULTS: A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %-24.2 % for anatomic reconstruction techniques, whereas a 0 %-36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %-12.1 %) following surgery. 0 %-8 % of patients required revision PLC surgery.
CONCLUSIONS: PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques.
METHODS: IV; Systematic Review of Level III and IV studies.
METHODS: A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping.
RESULTS: A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %-24.2 % for anatomic reconstruction techniques, whereas a 0 %-36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %-12.1 %) following surgery. 0 %-8 % of patients required revision PLC surgery.
CONCLUSIONS: PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques.
METHODS: IV; Systematic Review of Level III and IV studies.
摘要：
目的：回顾和更新关于慢性，后外侧角(PLC)III级损伤，重点是根据2019年专家共识，根据客观参数估算故障率，其次比较解剖与非解剖重建技术的失败率。
方法：使用PubMed进行了文献检索，Embase,MEDLINE和Cochrane图书馆数据库。纳入标准包括I-IV级人体临床研究，报告慢性（损伤后>6周）III级PLC损伤手术治疗后患者的主观和客观结果。至少随访两年。客观手术失败的标准基于术后内翻应力X线片，并定义为侧向间隙3mm或更大的侧向差异。
结果：共6项研究，由10个单独的队列组成，总共230名患者，已确定。在所有队列中进行PLC重建，这些队列中有80％（n=8/10）使用解剖重建技术。发现故障率为4.3%至36%。亚组分析显示，解剖重建技术的失败率为4.3％至24.2％，而非解剖重建的失败率为0％至36％。关节纤维化是最常见的并发症（范围，0%—12.1%）术后。0%～8%的患者需要进行PLC的翻修手术。
结论：根据术后内翻应力X线片上3mm或更大的侧向间隙的左右差异，PLC重建产生的失败率差异很大，解剖和非解剖重建技术后的翻修率低。
方法：IV；III级和IV级研究的系统评价。
方法：使用PubMed进行了文献检索，Embase,MEDLINE和Cochrane图书馆数据库。纳入标准包括I-IV级人体临床研究，报告慢性（损伤后>6周）III级PLC损伤手术治疗后患者的主观和客观结果。至少随访两年。客观手术失败的标准基于术后内翻应力X线片，并定义为侧向间隙3mm或更大的侧向差异。
结果：共6项研究，由10个单独的队列组成，总共230名患者，已确定。在所有队列中进行PLC重建，这些队列中有80％（n=8/10）使用解剖重建技术。发现故障率为4.3%至36%。亚组分析显示，解剖重建技术的失败率为4.3％至24.2％，而非解剖重建的失败率为0％至36％。关节纤维化是最常见的并发症（范围，0%—12.1%）术后。0%～8%的患者需要进行PLC的翻修手术。
结论：根据术后内翻应力X线片上3mm或更大的侧向间隙的左右差异，PLC重建产生的失败率差异很大，解剖和非解剖重建技术后的翻修率低。
方法：IV；III级和IV级研究的系统评价。
