Anatomic Posterolateral Corner Reconstruction With Single Tibialis Allograft and Suspensory Tibial Fixation

Injuries to the posterolateral corner (PLC) of the knee are difficult challenges for orthopaedic surgeons to manage. The original LaPrade anatomic reconstruction technique using 2 allografts from a split Achilles tendon has become a well-recognized reconstructive approach for addressing injury to the PLC. In this article, we present our modified technique of anatomic PLC reconstruction using a single tibialis allograft and suspensory tibial fixation. We describe the tunnel position, graft passage, and fixation strategies to achieve anatomic reconstruction of the 3 main stabilizers of the PLC (fibular collateral ligament, popliteus tendon, and popliteofibular ligament) while using a single allograft tendon. Suspensory fixation on the tibia is used to allow for individual tensioning of each limb of the reconstruction in an optimal knee position. We review the associated advantages, challenges, and technical pearls and pitfalls associated with our technique. We consider this modified approach a viable alternative to achieve a stable PLC reconstruction while still abiding by the established core anatomic reconstructive principles.