title: Screw loosening and iliotibial band friction after posterolateral corner reconstruction.
abstract: BACKGROUND
  Many reconstruction techniques have already been developed for treating posterolateral corner (PLC) injuries, with still no consensus regarding what would be the best option. Some techniques use non-bone tunnel fixation, attaching the graft to the femur using a cortical screw with toothed washer. The main objective of the present study is to evaluate complications related to fixation performed by a screw and toothed washer technique.
  
  
  METHODS
  A prospective study with surgical reconstruction of the PLC structures of the knee between January 2008 and December 2009 was performed. PLC reconstruction included reconstruction of the lateral collateral ligament, popliteofibular ligament and popliteal muscle tendon. Fixation of the grafts in the femur was achieved by means of a 4.5mm screw with a toothed washer. The assessments were done using the following methods: objective IKDC, subjective IKDC, Lysholm and Tegner. Radiographic evaluations were performed immediately after the operation, at 3, 6 and 12months after surgery, and yearly thereafter. Complications were documented.
  
  
  RESULTS
  The mean subjective IKDC score after the operation was 69.2; Lysholm scale was 80.7. Two patients presented failure of reconstructions of the PLC. In the radiographic evaluations, signs of loosening of the screw with toothed washer in the femur were observed in eight cases (66.6%). Six patients (50%) complained of lateral pain after the operation.
  
  
  CONCLUSIONS
  The technique of femoral fixation was shown to be efficient in restoration of stability. However there was a high rate of complications secondary to implant, such as loosening of the screws and iliotibial tract friction.
  
  
  METHODS
  Case series, leve IV.
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: Camilo Partezani
authors.initials: CP
authors.lastname: Helito
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil. Electronic address: bonadiob@yahoo.com.br.
authors.forename: Marcelo Batista
authors.initials: MB
authors.lastname: Bonadio
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: Marco Kawamura
authors.initials: MK
authors.lastname: Demange
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: Roberto Freire da Mota e
authors.initials: RF
authors.lastname: Albuquerque
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: José Ricardo
authors.initials: JR
authors.lastname: Pécora
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: Gilberto Luis
authors.initials: GL
authors.lastname: Camanho
authors.affiliation: Department of Orthopaedics and Traumatology, IOT-HCFMUSP (Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo), São Paulo, Brazil.
authors.forename: Fábio Janson
authors.initials: FJ
authors.lastname: Angelini
mesh_terms: D000328:Adult; D001863:Bone Screws / Q000009:adverse effects*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D065466:Lysholm Knee Score; D008297:Male; D009984:Orthopedic Fixation Devices; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013710:Tendons / Q000637:transplantation; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Dislocation; Knee; Loosening; Posterolateral corner; Screw