Weightbearing Protocols After Posterolateral Corner Reconstruction: A Systematic Review.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Rehabilitation Science

Background:

• Multiligamentous knee injuries, particularly those involving the posterolateral corner, are severe and debilitating.
• Effective rehabilitation is crucial for restoring function after complex knee trauma.

Purpose of the Study:

• To systematically review rehabilitation programs for multiligamentous knee reconstruction.
• To recommend optimal postoperative rehabilitation based on published outcomes.

Main Methods:

• Systematic review of Level 4 evidence.
• Searched MEDLINE, OVID, and Embase for studies on posterolateral corner injury and rehabilitation.
• Included studies with multiligamentous knee injuries and specific rehabilitation protocols.

Main Results:

• Analyzed 10 publications with 245 patients, categorizing protocols by weight-bearing (WB) status: delayed, progressive, and immediate.
• No significant difference in outcome scores was observed among the three WB groups.
• Delayed WB showed the highest complication rate (44%) and arthrofibrosis (11%), while progressive WB had the lowest (3%).

Conclusions:

• Immediate, progressive, and delayed WB protocols yield similar outcome scores for multiligamentous knee reconstruction.
• Progressive WB may reduce complication risks without compromising outcomes.
• Further research is needed to establish the optimal postoperative rehabilitation protocol due to data heterogeneity.