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Updated: May 9, 2025
Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts
Published on: October 20, 2023
All-Inside Bicruciate Ligament and Open Posterolateral Corner Reconstruction With Suture Augmentation
Matthew S Gwilt1, Jonathan D Groothoff1, Caleb D Puckett1
1Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Background:
Multiligamentous knee injuries (MLKIs) are complex, often highly traumatic injuries that require broad surgical techniques to restore joint stability. This study outlines novel surgical techniques for posterolateral corner (PLC) reconstruction with suture augmentation in the context of bicruciate reconstruction.
Indications:
Reconstruction is indicated in complete tears of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and PLC due to joint instability. Allografts augmented with suture augmentation may be implemented at surgeon and patient discretion for enhanced long-term graft viability and have the benefits of lower donor morbidity with allografts along with suture augmentation to prevent stretching of allografts.
Technique Description:
The ACL was reconstructed with all-inside tunnels and allograft usage, and the same was performed for single-bundle allograft PCL reconstruction. The PLC reconstruction consisted of a modified open Arciero technique in which the lateral collateral ligament (LCL) and popliteus were reconstructed using 1 continuous allograft, and additional suture augmentation was performed for the LCL to prevent stretching. The PCL was fixed first, after which the ACL and the PLC were fixed.
Results:
At 6 weeks postoperatively, the patient continues to progress in restoring passive range of motion and tolerance of partial weightbearing. Barring any potential complications, a full recovery is expected in approximately 9 to 12 months, as is consistent with the MLKI recovery protocol.
Discussion/Conclusion:
This study describes the surgical management of a Schenck knee dislocation class III-L injury with concomitant Arciero open PLC reconstruction in a 65-year-old man. The ideal strategy for reconstruction of MLKIs is unclear and warrants further evidence to help guide treatment in the context of concomitant injuries.
Patient Consent Disclosure Statement:
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
