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Arthroscopic Identification of the Knee Posterolateral Corner Structures and Anatomic Arthroscopic Posterolateral Corner Reconstruction: Technical Note - Part 2.

ABSTRACT: Posterolateral corner injuries are complex injuries, and their therapeutic management varies from one individual to another. Biomechanical studies demonstrate that anatomic posterolateral corner reconstruction restores knee kinematics better than nonanatomic reconstruction. The purpose of this report is to describe an all-arthroscopic procedure for anatomic posterolateral corner reconstruction.

SUBMITTER: Freychet B

PROVIDER: S-EPMC7768287 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Arthroscopic Identification of the Knee Posterolateral Corner Structures and Anatomic Arthroscopic Posterolateral Corner Reconstruction: Technical Note - Part 2.

Freychet Benjamin B Sonnery-Cottet Bertrand B Vieira Thais Dutra TD Sanders Thomas L TL Kennedy Nicholas I NI Krych Aaron J AJ Stuart Michael J MJ Levy Bruce A BA

Arthroscopy techniques 20201221 12

Posterolateral corner injuries are complex injuries, and their therapeutic management varies from one individual to another. Biomechanical studies demonstrate that anatomic posterolateral corner reconstruction restores knee kinematics better than nonanatomic reconstruction. The purpose of this report is to describe an all-arthroscopic procedure for anatomic posterolateral corner reconstruction. ...[more]

PMID: 33381409

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Arthroscopic Identification of the Knee Posterolateral Corner Structures and Anatomic Arthroscopic Posterolateral Corner Reconstruction: Technical Note - Part 1.

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Minimally Invasive, Arthroscopic-Assisted, Anatomic Posterolateral Corner Reconstruction.

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Anatomic Reconstruction of the Posterolateral Corner: An All-Arthroscopic Technique.

Project description:Injuries of the posterolateral corner (PLC) of the knee lead to chronic lateral and external rotational instability. Successful treatment of PLC injuries requires an understanding of the complex anatomy and biomechanics of the PLC. Several open PLC reconstruction techniques have been published. It is understood that anatomic reconstruction is superior to extra-anatomic techniques, leading to better clinical results. An open, anatomic, fibula-based technique for reconstruction to address lateral and rotational instability has been described. However, when an open technique is used, surgeon and patient are faced with disadvantages, such as soft tissue damage or exposure of vulnerable structures. Few arthroscopic techniques for tibia- or fibula-based reconstruction of rotational posterolateral instability have been described. A complete arthroscopic stabilization of the combined lateral and posterolateral rotational instability of the knee has not yet been described. We therefore present the first all-arthroscopic technique for complete PLC reconstruction, based on an open technique described previously. All relevant landmarks of the PLC can be arthroscopically visualized in detail, allowing safe and effective treatment of PLC injuries.

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Anatomic Posterolateral Corner Reconstruction.

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Project description:The posterolateral corner (PLC) is an important stabilizer of the knee. This complex of ligaments and tendons functions as the primary restraint to varus and posterolateral rotation of the knee. Injury to the PLC can result in chronic instability, a varus-thrust gait, and early arthrosis of the medial compartment of the knee if left untreated. Several techniques have been designed to address injuries of the PLC. Over the last 30 years, our understanding of the posterolateral corner as well as its operative reconstruction evolved. This evolution has attempted to refine what is an "anatomic" reconstruction. With more improved techniques and new, innovative fixation devices, we hope to make a more favorable repair for recreating the native stability of the posterolateral corner.

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Anatomic Posterolateral Corner Reconstruction With Autogenous Peroneus Longus Y Graft Construct.

Project description:The posterolateral corner of the knee is composed of the fibular collateral ligament, popliteus tendon, and popliteofibular ligament, which provide varus and rotational stability to the knee. An anatomic technique reconstructs these structures through 2 femoral sockets and 1 tibial and 1 fibular tunnel. This reconstruction can be performed using a peroneus longus autograft that is prepared as a Y construct. The peroneus longus autograft is preferred because it provides adequate length and diameter for the entire reconstruction. Initially, the doubled loop of the Y is passed into the tibial tunnel and fixed with an adjustable cortical button. The shorter limb of the Y is used for reconstruction of the popliteus tendon. The longer limb of the Y is passed from posterior to anterior through the fibular tunnel and is fixed in the tunnel with an interference screw to re-create the popliteofibular ligament. The remaining graft is then shuttled deep to the iliotibial band and superficial to the popliteus tendon, into the femoral socket, to re-create the fibular collateral ligament.

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