Posterolateral Corner Reconstruction: Surgical Technique and Postoperative Rehabilitation

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Biomechanics

Background:

• Posterolateral corner (PLC) knee injuries often result in ligamentous instability, impacting patients' ability to maintain active lifestyles.
• Various surgical techniques exist for PLC reconstruction, but anatomic restoration of primary stabilizers is key.

Purpose of the Study:

• To describe the anatomic reconstruction technique for the posterolateral corner (PLC) of the knee, focusing on restoring the fibular collateral ligament (FCL), popliteal tendon (PLT), and popliteofibular ligament (PFL).
• To highlight the advantages of anatomic PLC reconstruction over nonoperative management and primary repair, particularly for grade-III injuries.

Main Methods:

• Anatomic reconstruction of the FCL and PLT using techniques described by LaPrade et al.
• Focus on restoring the three primary stabilizers of the PLC to their native footprint.
• Consideration for associated injuries, including cruciate ligament tears and proximal tibiofibular joint instability.

Main Results:

• Anatomic PLC reconstruction demonstrates significantly improved objective stability compared to nonoperative treatment or primary repair.
• Improved subjective and objective patient outcomes are associated with anatomic reconstruction.
• Fibular-based techniques show good clinical outcomes for chronic isolated PLC injuries, restoring varus and rotational stability.

Conclusions:

• Anatomic PLC reconstruction is recommended for grade-III PLC injuries, offering superior outcomes and lower reoperation rates compared to primary repair.
• This technique provides excellent functional recovery and stability, enabling patients to return to active lifestyles.
• Careful surgical technique is crucial to minimize risks such as common peroneal nerve damage and malalignment.