Achilles Tendon Allograft Reconstruction of the Fibular Collateral Ligament and Posterolateral Corner

Schechinger, Steve J.; Levy, Bruce A.; Dajani, Khaled A.; Shah, Jay P.; Herrera, Diego A.; Marx, Robert G.

doi:10.1016/j.arthro.2008.09.017

Cited by 69 publications

(71 citation statements)

References 22 publications

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“…The reconstruction with double-femoral-tunnel technique included two femoral tunnels with two separate limbs of soft tissue graft to simulate the function of the LCL and PFL, which explained the experimental results of better rotational control. Apart from using the tendon graft of tibialis anterior for the reconstruction, literature suggested using Achilles tendon allograft 9 , split Achilles tendon allograft 26 for reconstructing PLC with double-femoral-tunnel technique.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of 2 Surgical Techniques for Reconstructing Posterolateral Corner of the Knee: A Cadaveric Study Evaluated by Navigation System

Lam

Chung

et al. 2011

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Methodsmentioning

confidence: 99%

“…The understanding of anatomy and biomechanics of PLC was improved in the past two decades, but the best technique to reconstruct PLC was not well established 3,5,[8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of 2 Surgical Techniques for Reconstructing Posterolateral Corner of the Knee: A Cadaveric Study Evaluated by Navigation System

Lam

Chung

et al. 2011

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…17 A comparison of our PLC reconstruction in knees with injuries to 2 ligaments versus multiligamentinjured knees showed no significant difference between groups in International Knee Documentation Committee (IKDC) or Lysholm scores or clinical stability. 12 Recently, Geeslin and LaPrade 18 and Camarda et al 19 reported satisfactory outcomes with mean IKDC scores of 89.5 and 88.5, respectively, for isolated PLC reconstructions using a fibular tunnel. For combined PLC and cruciate injuries, Geeslin and LaPrade reported a mean IKDC score of 78.5.…”

Section: Discussionmentioning

confidence: 99%

“…This article and Video 1 have presented our preferred PLC reconstruction technique, which we have previously reported. 12 Careful planning and accurate reconstruction of the injured PLC structures can help restore native knee kinematics and provide satisfactory clinical and functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of the Posterolateral Corner of the Knee With Achilles Tendon Allograft

Kuzma

Chow

Engasser

et al. 2014

Arthroscopy Techniques

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Posterolateral corner injuries of the knee are relatively rare; however, they can result in significant long-term disability without appropriate treatment. They often occur in the setting of multiligament knee injuries, and as a result, diagnosis and management can be challenging. Severe injuries often require reconstruction, and both anatomic and nonanatomic techniques exist. We describe our preferred operative technique to reconstruct the fibular collateral ligament and posterolateral corner using a single Achilles tendon allograft. Injuries to the posterolateral corner (PLC) of the knee commonly occur as a result of high-energy trauma involving hyperextension and either a varus or externalrotation force about the knee. Frequently, other ligaments are also injured; this makes accurate diagnosis and subsequent management challenging.The anatomy of the PLC is complex. The major structures include the fibular collateral ligament (FCL), the popliteofibular ligament (PFL), and the posterolateral capsule, which are the primary static stabilizers, and the popliteus tendon, which is an important dynamic and static stabilizer. Combined, these structures provide restraint to both posterolateral rotation of the tibia and varus opening forces.Reconstruction of PLC injuries is an evolving concept, and numerous techniques have been developed with slight variations. [1][2][3][4][5][6][7][8][9][10][11] In this article we describe our preferred technique, which uses a single Achilles tendon allograft, with anatomic fibular and femoral tunnels and a posterolateral capsular shift (Fig 1). This technique was developed by the senior author (B.A.L.) and is less complex than some anatomic reconstruction techniques because of elimination of the transtibial tunnel, but it still takes into account the posterolateral stabilizers of the knee and their respective anatomic relations. 12 Illustrative CaseA 16-year-old boy presented with left knee instability after a hyperextension injury during football that occurred approximately 4 weeks before presentation. At the time of the injury, he felt a pop and tearing sensation in the back and lateral aspects of the knee. He had immediate posterolateral knee pain, numbness to the dorsum of the foot, and instability with any attempt at weight bearing. In the 4 weeks that ensued, his numbness spontaneously resolved. Physical examination at presentation showed 1þ effusion, a negative Lachman test, positive posterior drawer and posterior sag tests, positive dial tests at both 30 and 90 , a positive external rotation drawer test, and a positive Marx spin test. In addition, the patient had 2þ opening to varus stress at full extension and at 30. He was found to be neurovascularly intact on presentation. The examination findings were consistent with a complete disruption of the posterior cruciate ligament (PCL) and the PLC. For the purposes of this illustrative case and technique, we will focus only on treatment of the PLC. Magnetic resonance imaging showed a complete PCL tear and PLC injury, wi...

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Surgical Treatment of Combined ACL Medial and Lateral Side Injuries: Acute and Chronic

Wasserman¹,

West

2013

The Multiple Ligament Injured Knee

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Achilles Tendon Allograft Reconstruction of the Fibular Collateral Ligament and Posterolateral Corner

Cited by 69 publications

References 22 publications

Comparison of 2 Surgical Techniques for Reconstructing Posterolateral Corner of the Knee: A Cadaveric Study Evaluated by Navigation System

Comparison of 2 Surgical Techniques for Reconstructing Posterolateral Corner of the Knee: A Cadaveric Study Evaluated by Navigation System

Reconstruction of the Posterolateral Corner of the Knee With Achilles Tendon Allograft

Surgical Treatment of Combined ACL Medial and Lateral Side Injuries: Acute and Chronic

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