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Comparison of 2 surgical techniques for reconstructing posterolateral corner of the knee: a cadaveric study evaluated
Eric Po-Yan Ho1, Mak-Ham Lam, Mandy Man-Ling Chung
1Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Purpose:
This study aimed to evaluate the immediate effect on knee kinematics by 2 different techniques of posterolateral corner (PLC) reconstruction.
Methods:
Five intact formalin-preserved cadaveric knees were used in this study. A navigation system was used to measure knee kinematics (posterior translation, varus angulation, and external rotation) after application of a constant force and torque to the tibia. Four different conditions of the knee were evaluated during the biomechanical test: intact knee and PLC-sectioned knee and PLC-reconstructed knee by the double-femoral tunnel technique and single-femoral tunnel technique.
Results:
Sectioning of the PLC structures resulted in significant increases in external rotation at 30° of flexion from 11.2° (SD, 2.6) to 24.6° (SD, 6.2), posterior translation at 30° of flexion from 3.4 mm (SD, 1.5) to 7.4 mm (SD, 3.8), and varus angulation at 0° of flexion from 2.3° (SD, 2.1) to 7.9° (SD, 5.1). Both reconstruction techniques significantly restored the varus stability. The external rotation and posterior translation at 30° of flexion after reconstruction with the double-femoral tunnel technique were 10.2° (SD, 1.3) and 3.4° (SD, 2.7), respectively, which were significantly better than those of the single-femoral tunnel technique.
Conclusions:
Both techniques of reconstruction showed improved stability compared with PLC-sectioned knees. The double-femoral tunnel technique in PLC reconstruction showed better rotational stability and resistance to posterior translation than the single-femoral tunnel technique without compromising varus stability.
Clinical Relevance:
PLC reconstruction by a double-femoral tunnel technique achieves better rotational control and resistance to posterior translation.
