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Updated: May 27, 2026
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Arthroscopic Excision of Posterior Cruciate Ligament Cysts Using a Double Posteromedial Approach
Published on: October 20, 2023
Combined PCL and PLC reconstruction in chronic posterolateral instability
Claudio Zorzi1, Mahbub Alam, Venanzio Iacono
1Department of Orthopaedics and Traumatology, Knee Surgery Centre, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy.
Summary
Combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) reconstruction improved knee stability and function in patients, though some laxity remained. This surgery is a viable option for complex knee injuries.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Biomechanics
Background:
- Posterolateral corner (PLC) injuries often occur with posterior cruciate ligament (PCL) or anterior cruciate ligament (ACL) tears, leading to significant knee instability and functional deficits.
- Isolated PLC injuries are less common, but combined injuries present complex challenges in restoring knee stability and function.
Purpose of the Study:
- To evaluate the efficacy of combined arthroscopic-assisted single-bundle PCL and PLC reconstruction in improving knee stability, patient symptoms, and function.
- To determine if this combined surgical approach can restore sufficient knee stability to allow for improved patient outcomes.
Main Methods:
- Retrospective analysis of 19 patients who underwent arthroscopic-assisted single-bundle PCL and PLC reconstruction.
- PLC reconstruction utilized a modified Larson technique for the lateral collateral ligament and popliteofibular ligament.
- Outcomes were assessed using the International Knee Documentation Committee (IKDC) and Tegner scores, with clinical laxity evaluated by dial test, varus stress tests, and KT-1000 posterior laxity testing.
Main Results:
- No postoperative complications were reported in the 19 patients at a mean follow-up of 38 months.
- Significant improvements in clinical laxity were observed, with 17 of 19 patients demonstrating negative dial and varus stress tests and less than 5 mm posterior step-off.
- Tegner scores improved from a median of 2 to 6, and the mean postoperative IKDC score was 86, indicating enhanced function and subjective stability, despite a mean 10° reduction in range of motion.
Conclusions:
- Combined PCL and PLC reconstruction subjectively restored knee stability, enabling patients to perform daily activities without restrictions.
- While functional outcomes and stability improved, residual abnormalities in range of motion and rotational laxity suggest that normal knee biomechanics were not fully restored.
- The surgical technique offers a viable option for managing combined PCL and PLC injuries, improving patient-reported outcomes and stability.