Reconstruction of the Posterior Oblique Ligament and the Posterior Cruciate Ligament in Knees With Posteromedial Instability

Surgical Techniques for the Reconstruction of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review

“…Furthermore, outdated literature may propagate this nonanatomic surgical technique in medial knee reconstruction, including sources that errantly identify the medial epicondyle as the proximal sMCL attachment [51][52][53] and techniques that use it for femoral fixation or assessments of isometry. 8,42,27,35,50,44,14 More contemporary anatomic and radiographic studies have more accurately characterized femoral-sided medial structures, which specifically indicate that the correct proximal femoral attachment of the sMCL is 3.2 mm proximal and 4.8 mm posterior to the medial epicondyle. 28,29 Alternatively, other investigators have recommended the use of radiographic landmarks in isometric, femoral tunnel placement, referencing the anterior aspect of the posterior femoral line as it intersects with Blumenstaat's line on a perfect lateral fluoroscopy image.…”

“…41 In addition, autologous tissue may have questionable tissue quality after acute knee dislocation. The use of double-bundle graft constructs 8,42,36,39,[43][44][45] increases technical complexity, often resulting in multiple bone tunnels and different points of fixation with additional hardware, which may add bulk to the final construct. 11 Triple and quadruple bundle semitendinosus/gracillis autografts involving various looping techniques, figureof-8, or triangular routing configurations have also been described.…”

Naht und Refixation des medialen Kollateralbandkomplexes bei schwerer akuter medialer Instabilität des Kniegelenks

“…Treten komplette Rupturen des medialen Bandkomplexes jedoch im Rahmen einer Knieluxation auf, stellen diese eine Operationsindikation dar [1,12,13,14,15,16,17]. Da chronische mediale und posteromediale Instabilitäten ein Grund für schlechte Resultate nach Rekonstruktion des HKB sein können, sollten Verletzungen des MCL und des POL als häufige Begleitverletzung der HKB-Ruptur nicht übersehen werden und auch adressiert werden [1,18,19,20]. Hinweisend auf diese Verletzungen ist eine drittgradige Valgusin- …”

Evaluation and Treatment of Medial Instability of the Knee

“…[1][2][3] The large number of basic science and anatomy publications reflects the increasing interest in the medial side of the knee. [4][5][6][7][8][9][10][11][12][13] There have also been many review articles published in the past decade that summarize many aspects of medial side treatments. [14][15][16][17][18][19][20][21][22][23][24] Many of these publications are recognizing the differences between a torn medial collateral ligament (MCL) and a torn posteromedial corner (PMC).…”

“…An increased understanding of knee anatomy and biomechanics has led to the design of a number of reconstructions that increasingly attempt to replicate the normal PMC. [1][2][3]10,15 All of the techniques are slightly different but all reconstruct the superficial MCL as well as the posterior oblique ligament (POL). None of them perfectly replicates the dynamic stabilizers, but all report success rates that far exceed historic results with complex medialsided knee injuries.…”