Long-term clinical outcomes of combined BPTB ACL reconstruction and popliteus tendon plasty

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2015-10, Vol.23 (10), p.2930-2935
• Main Authors: Marcacci, Maurilio, Bonanzinga, Tommaso, Grassi, Alberto, Musiani, Costanza, Benzi, Andrea, Muccioli, Giulio Maria Marcheggiani, Vaccari, Vittorio, Zaffagnini, Stefano
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anterior Cruciate Ligament Reconstruction; Bone-Patellar Tendon-Bone Grafting; Clinical outcomes; Female; Follow-Up Studies; Humans; Joint Instability - surgery; Knee; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Patient Outcome Assessment; Retrospective Studies; Tendons - surgery
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-015-3673-x

Purpose A deficiency of posterolateral structures significantly increases the varus load on the ACL, while a chronic ACL lesion, the increased tibial rotation and the repetitive non-physiological knee motion, could affect and damage the integrity of the popliteus tendon. Therefore, the aim of the present study was to report the very long clinical outcomes of a combined single-bundle BPTB ACL reconstruction and popliteus plasty according to Bousquets technique, for the treatment of combined chronic anterior and posterolateral laxities. Methods Fifteen patients that underwent combined ACL reconstruction and popliteal plasty according to Bousquets technique were available at mean 26.8 ± 1.0 years (range 25.4–28.0 years). All the patients were evaluated clinically and 13 by means of KT-1000 Arthrometer as well. Subjective evaluation was performed with the subjective IKDC, WOMAC and a 0–10 VAS for pain scales. Results At clinical evaluation, 10 patients (67 %) presented a negative anterior drawer test; Lachman test was negative in nine patients (60 %); the varus stress test was negative in eight (53 %); and the dial test was negative in all but one patient (93 %). Only two patients (15 %) presented a side-to-side difference >5 mm at the instrumented laxity evaluation. Conclusion The combined single-bundle BPTB ACL reconstruction and popliteal plasty according to Bousquets technique were able to produce very good long-term results, in terms of knee stability, subjective outcomes, functional results and return to sport activity, in case of chronic anterior and posterolateral laxities. Level of evidence Retrospective case series, Level IV.