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The Journal of Bone and Joint Surgery, Vol 60, Issue 8 1015-1030, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Anterior subluxation of the lateral tibial plateau. A diagnostic test and operative repair
RE Losee, TR Johnson and WO Southwick
Recurrent anterior subluxation of the lateral tibial plateau is a common
type of chronic knee instability resulting from trauma. It can be
reproduced by the clinical test described and corrected by a surgical
procedure called the sling and reef operation, in which a strip of
iliotibial tract is used to create a sling and to reef the posterolateral
capsule. From 1971 to 1978, eighty-four patients were operated on, of whom
fifty had been evaluated at one to six and one-half years after operation.
The results were: forty-one good, six fair, and three poor. The lesions
found in the thirty-seven knees in which arthrotomy was performed included
a tear of the anterior cruciate in every case, a tear of the medial
meniscus in fifteen and of the lateral meniscus in eleven, a notch in the
articular surface of the lateral femoral condyle in fifteen, and a lateral
marginal tibial (Segond) fracture in three. No definite lateral capsular
tears were visualized--only stretching comparable to that seen in recurrent
dislocation of the shoulder.
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