Anatomic reconstructive surgery for posterolateral instability of the knee

Area of Science:

• Orthopedic surgery
• Knee reconstruction
• Sports medicine

Background:

• Posterolateral instability of the knee requires effective surgical reconstruction.
• Existing techniques like the posterolateral corner sling procedure have limitations.

Purpose of the Study:

• To describe an anatomic reconstructive surgical procedure for the fibular collateral ligament, popliteal tendon, and popliteofibular ligament using split Achilles allograft.
• To compare the clinical results of this anatomic reconstruction with the posterolateral corner sling procedure for knee posterolateral instability.

Main Methods:

• A case series comparing two surgical techniques for posterolateral knee instability.
• Forty-six patients were divided into two groups: 25 (group A) had the posterolateral corner sling procedure, and 21 (group B) had anatomic reconstructive surgery.
• Follow-up was a minimum of 12 months, including arthroscopic evaluation, Lysholm knee scores, varus laxity, and tibial external rotation assessment.

Main Results:

• Both groups showed significant improvement in Lysholm knee scores post-surgery (Group A: 54.8 to 86.9; Group B: 54.4 to 93.6).
• Anatomic reconstruction (Group B) resulted in significantly less residual tibial external rotation (5% vs 12%) and varus laxity (14% vs 28%) compared to the sling procedure (Group A).

Conclusions:

• Anatomic reconstruction of the posterolateral corner is superior to the posterolateral corner sling procedure.
• The described anatomic technique effectively reduces varus laxity and tibial external rotation in patients with knee posterolateral instability.