Posterolateral Corner Reconstruction Alone Using a Fibular-Based Technique in a Patient with Persistent Unstable...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Biomechanics

Background:

• Posterolateral rotatory instability is an uncommon complication of total knee arthroplasty (TKA).
• Standard treatments involve revision with constrained designs or thicker polyethylene liners, which may not resolve persistent instability.
• Recalcitrant instability poses a significant challenge in TKA management.

Purpose of the Study:

• To present a case of persistent posterolateral rotatory instability after multiple revision total knee arthroplasties.
• To evaluate the efficacy of a fibular-based posterolateral corner reconstruction as a salvage procedure.
• To demonstrate a potential soft-tissue solution for complex TKA instability.

Main Methods:

• A patient with chronic instability after TKA underwent several revision surgeries without success.
• A fibular-based posterolateral corner reconstruction using a tibialis anterior allograft was performed.
• Clinical outcomes and stability were assessed at 1-year follow-up.

Main Results:

• The patient remained unstable despite polyethylene liner exchange and more constrained TKA revisions.
• Following the fibular-based posterolateral corner reconstruction, the patient achieved stability.
• At 1-year follow-up, the patient was asymptomatic with excellent functional outcomes.

Conclusions:

• A fibular-based posterolateral corner reconstruction can be an effective soft-tissue-only solution for persistent posterolateral rotatory instability after total knee arthroplasty.
• This technique offers a viable option when conventional revision strategies fail.
• Restoring posterolateral stability through soft-tissue procedures can significantly improve function in TKA patients.