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Posteromedial corner injury in knee dislocations
James P Stannard1, Brandee S Black, Chris Azbell
1Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO 65212, USA. stannardj@health.missouri.edu
The Journal of Knee Surgery
|November 15, 2012
Summary
Surgical reconstruction of the posteromedial corner (PMC) in knee dislocations shows significantly lower failure rates than repair. Reconstruction offers better knee stability for PMC injuries.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Biomechanics
Background:
- Posteromedial corner (PMC) injuries often occur with knee dislocations.
- Limited data exists for optimal surgical management of PMC injuries.
- Accurate treatment decisions require comparative outcome data.
Purpose of the Study:
- To compare surgical repair versus reconstruction outcomes for PMC injuries in knee dislocations.
- To evaluate the efficacy of different PMC treatment strategies.
- To identify the superior surgical approach for restoring knee stability.
Main Methods:
- Retrospective study of 71 knee dislocation patients with 73 PMC tears.
- Group A: PMC repair (25 patients).
- Group B: Autograft PMC reconstruction (48 patients).
- Group C: Allograft PMC reconstruction (not detailed in results).
- Mean follow-up of 43 months.
Main Results:
- PMC repair group had a 20% failure rate (5/25).
- PMC reconstruction group had a 4% failure rate (2/48).
- A significant difference in failure rates between repair and reconstruction was observed.
- Reconstruction reestablishing the critical triangle yielded better stability.
Conclusions:
- Surgical reconstruction of the PMC demonstrates a significantly lower failure rate compared to primary repair.
- Reconstruction techniques that restore the medial collateral ligament, posterior oblique ligament, and semitendinosus are superior.
- These findings support reconstruction for managing PMC instability in knee dislocations.
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