Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation

摘要: OBJECTIVES The arthroscopic "lateral gutter drive-through" (LGDT) sign is reported to diagnose popliteus tendon (PT) injury with high sensitivity and specificity. However, no study has provided a postoperative evaluation of combined posterior cruciate ligament (PCL) posterolateral corner (PLC) injuries using the LGDT test. METHODS From January 2012 2015, total 80 consecutive patients who underwent PCL reconstruction PLC surgeries were identified. Fifty eligible included in this for subjective scoring systems, physical examinations, varus stress radiographs, second-look during hardware removal operation. RESULTS Forty-nine available mean 31.5 ± 9.3 months follow-up (range, 24.0-81.0 months). In terms pattern, there 27 type A, 10 B, 12 C patients, 21 acute cases 28 chronic cases. At final follow-up, scores all significantly improved. side-to-side difference (SSD) tibial translation (PTT) improved from 18.4 ± 9.2 mm 12.9-25.6 mm) 5.2 ± 5.0 -5.0-18.5 mm, P < 0.001), SSD external rotation by dial test (ER) decreased 18.0° ± 14.4° 13.0°-22.0°) 1.2° ± 7.5° -9.0°-22.0°, P < 0.001). injury, lateral opening 14.2 ± 6.6 22-10.2 0.9 ± 3.1 -4.4-6 comparison between positive negative signs, LGDT-negative had significant superiority scores, PTT, ER. specificity detecting rotational instability (PLRI) calculated as 100% 88.4%, respectively. CONCLUSIONS series surgically treated injury: (i) objective clinical outcome after surgery at minimum 24-months follow-up; (ii) second testing PLRI, was related inferior results.