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Posterolateral Corner Reconstruction Using Double Femoral Fixation With Adjustable Loop Cortical Suspension and
Nicholas I Kennedy1, Erik Therrien2, Robert G Marx3
1Mayo Clinic, Rochester, Minnesota, USA.
Video Journal of Sports Medicine
|May 1, 2025
Summary
This study introduces a new surgical technique for posterolateral corner (PLC) knee reconstruction using adjustable loop cortical suspensory fixation. This method allows for precise graft tensioning, aiming to improve outcomes and reduce instability after PLC repair.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Anatomy
Background:
- The posterolateral corner (PLC) of the knee involves complex structures including the popliteus tendon, popliteofibular ligament (PFL), and fibular collateral ligament (FCL).
- Treatment for PLC injuries is guided by the degree of varus and rotational instability, with Grade 3 injuries often requiring surgical intervention.
Purpose of the Study:
- To describe a novel surgical technique for PLC reconstruction.
- To enable optimal and individual tensioning of the popliteus and FCL grafts using adjustable loop cortical suspensory fixation.
Main Methods:
- Utilizes adjustable loop cortical suspensory fixation implants (TightRope RT) for initial femoral fixation of popliteus and FCL grafts.
- Involves creating anatomic fibular tunnels and femoral sockets, followed by graft passage and tensioning before definitive fixation with interference screws.
- Includes a posterolateral capsular shift for enhanced knee stability.
Main Results:
- Adjustable loop cortical suspensory devices allow for independent, optimal graft tensioning before final fixation.
- This technique presumably limits residual graft creep and provides dual femoral fixation.
- Reported failure rates for PLC reconstruction range from 6% to 9.4%.
Conclusions:
- The described technique offers a method for precise, individualized graft tensioning in PLC reconstruction.
- By utilizing validated graft choices and anatomic landmarks, this technique is expected to yield outcomes comparable to or better than current standards.
