Anatomic reconstruction of the posterolateral corner of the knee: a case series with isolated reconstructions in 27 patients

Abstract

Purpose: This study presents clinical results of a case series of isolated reconstruction of the posterolateral corner (PLC) with a new technique that aims to reconstruct the lateral collateral ligament (LCL), popliteus tendon, and popliteofibular ligament.

Methods: From 1997 to 2005, 27 patients available for follow-up with isolated posterolateral instability were treated with primary reconstruction of the LCL and PLC. The median age was 28 years, and there were 16 male patients. Of the patients, 26% had remaining instability after anterior or posterior cruciate ligament reconstruction. All underwent reconstruction with a novel technique addressing both the LCL and the PLC by use of hamstring autografts. Follow-up was more than 24 months, and patients were examined by an independent observer using the International Knee Documentation Committee objective measures and subjective Knee Injury and Osteoarthritis Outcome Scores.

Results: In our series 95% of patients with isolated lateral rotatory instability had rotatory stability after PLC reconstruction. On the basis of International Knee Documentation Committee scoring, 71% were normal or nearly normal. Subjective Knee Injury and Osteoarthritis Outcome Scores were comparable to scores in patients after meniscectomy. One patient had a deep infection, but none had any peroneal nerve injury.

Conclusions: This case series presents a new method for combined reconstruction of the LCL and the PLC. Despite the extensiveness of procedure, complications were low. The technique restores lateral stability clinically at 2 years' follow-up.

Level of evidence: Level IV, therapeutic case series.