title: Rotational profile alterations after anatomic posterolateral corner reconstructions in multiligament injured knees.
abstract: OBJECTIVE
  Injuries of the posterolateral corner (PLC) are rare and severe knee injuries, resulting in posterolateral rotatory instability and an increase in external rotation. Surgical reconstruction techniques reproducing the normal anatomy showed promising results. In vivo evaluations of static rotational knee laxity at 30° of knee flexion have not been reported so far. The purpose of this study was to evaluate static rotational knee laxity after anatomic PLC reconstructions.
  
  
  METHODS
  This is a retrospective clinical cohort study. Twenty patients with PLC reconstructions with an average follow-up time of 39 ± 22 months and no history of knee trauma or surgery of the contralateral knee were included in the study. They underwent a routine clinical examination and static rotational laxity measurements at 30° of knee flexion in the prone position. Side-to-side differences were recorded and compared to a group of matched controls.
  
  
  RESULTS
  The postoperative IKDC score was graded A for 8 patients, B for 16, C for 6 and D for one patient. The primary goal of the surgical procedure which consists in reducing excessive external tibiofemoral rotation could be reached in 18 of the 20 patients (90%). Anatomic PLC reconstructions yielded a comparable rotational profile in operated and healthy knees in 7 patients (35%). Thirteen patients (65%) presented a significantly altered rotational profile in comparison with a healthy control group. Unexpected increases in internal rotation were found in 8 patients (40%).
  
  
  CONCLUSIONS
  Anatomic PLC reconstructions reduced excessive external tibiofemoral rotation in a vast majority of patients. Static rotational laxity measurements allowed for a determination of the patients' individual rotational profile after PLC reconstructions. This profile was normalised in only one-third of the patients. The understanding of this finding needs further investigation as well as the clinical impact of rotational profile alterations on knee function.
  
  
  METHODS
  Diagnostic studies, Level III.
authors.affiliation: Centre Hospitalier de Versailles, 177 rue de Versailles, 78157, Le Chesnay, France, nicolastardy@aol.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Tardy
authors.forename: Caroline
authors.initials: C
authors.lastname: Mouton
authors.forename: Philippe
authors.initials: P
authors.lastname: Boisrenoult
authors.forename: Daniel
authors.initials: D
authors.lastname: Theisen
authors.forename: Philippe
authors.initials: P
authors.lastname: Beaufils
authors.forename: Romain
authors.initials: R
authors.lastname: Seil
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012399:Rotation; D055815:Young Adult