Anatomic Posterolateral Corner Reconstruction

Self Cite

As the anatomy and biomechanics of the posterolateral corner (PLC) of the knee have become better understood, the importance of the PLC's proper function has become a more frequently raised subject. Misdiagnosed chronic posterolateral instability may lead to serious consequences, including cruciate ligament reconstruction graft failure. It has been proved that high-grade PLC injuries need to be treated operatively. Surgical approaches vary, and techniques are still developing. Considering avoidance of an extended surgical approach and minimizing the risk of common peroneal nerve or popliteal artery injuries, we developed the minimally invasive, arthroscopic-assisted, anatomic PLC reconstruction.

Section: Discussionmentioning

confidence: 99%

Minimally Invasive, Arthroscopic-Assisted, Anatomic Posterolateral Corner Reconstruction

Hermanowicz¹,

Malinowski²,

Góralczyk³

et al. 2019

Self Cite

“…All tests should be performed bilaterally to allow comparison with the uninjured knee. 1 , 5 , 6 , 7 , 8 , 9 …”

Section: Physical Examination and Imaging Findingsmentioning

confidence: 99%

“…Magnetic resonance imaging can help in diagnosing acute lesions and concurrent injuries, as well as determining the location of the damaged structures. 8 , 9 …”

Section: Physical Examination and Imaging Findingsmentioning

confidence: 99%

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Anatomic Posterolateral Corner Reconstruction With Autografts

Franciozi

Albertoni

Gracitelli

et al. 2018

Anatomic posterolateral corner reconstruction reproduces 3 main structures: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. The LaPrade technique reproduces all 3 main stabilizers. However, it requires a long graft, limiting its indication to clinical settings in which allograft tissue is available. We propose a surgical procedure that is a modification of the LaPrade technique using the same tunnel placement, hamstring autografts, and biceps augmentation when necessary. It relies on artificial graft lengthening provided by the loop of the suspensory fixation device fixed at the anterior tibial cortex. The final reconstruction reproduces the popliteus tendon with the bulkiest end of the semitendinosus; the popliteofibular ligament with a strand of the semitendinosus and a strand of the gracilis; and the lateral collateral ligament with a strand of the semitendinosus and a strand of the gracilis, which can also be augmented with a biceps strip.

“… 11 published a technique for an anatomic reconstruction, attempting to recreate the FCL, PFL, and popliteus based on their native attachment sites. 12 This has been shown to both biomechanically improve varus and rotatory laxity of the knee and produce good medium- to long-term clinical results. 13 The reconstruction includes 2 separate grafts for the FCL and PFL/popliteus limbs and was originally described with the use of a split tendo-Achilles allograft.…”

mentioning

confidence: 99%

Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device

Wood

Robinson

Getgood

2019

The original description of the LaPrade technique for anatomic posterolateral corner reconstruction addresses the 3 main stabilizing structures: the fibular collateral ligament, the popliteus, and the popliteofibular ligament. The use of two separate grafts (originally described with a tendo-Achilles allograft) may restrict the utility of the technique when sources of allograft may be limited and autografts must be used, particularly in the context of multiligament reconstruction. We present a modification of the technique, in which an adjustable cortical button is used for tibial fixation, which allows for the use of a single graft while maintaining the ability to independently tension the popliteus, popliteofibular ligament, and fibular collateral ligament limbs of the graft.