Posterolateral corner ligament reconstruction in knee arthroscopy: Complications and complication management

The posterolateral corner (PLC), composed of three static stabilizers including the fibular collateral ligament, popliteus tendon, and popliteofibular ligament, collectively provide posterolateral knee stability (varus and external rotation). Disruption of this complex typically occurs in the setting of concomitant multi-ligament knee injuries (MLKI), typically requiring surgical management for restoration of knee stability. Anatomic surgical reconstructions have been shown to outperform non-anatomic reconstructions or repairs, yet are technically challenging and are not exempt of complications. The present review will address the anatomy and biomechanics of the involved structures, detail the senior author's anatomic three ligament tibiofemoral based reconstruction technique, and provide tips and tricks for avoiding the most frequently associated intraoperative and postoperative complications.