Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device

Wood, Ryan; Robinson, James R.; Getgood, Alan

doi:10.1016/j.eats.2018.11.011

Cited by 17 publications

(20 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Larger thicknesses of both the FCL and PLT are obtained, and significantly improved subjective and objective clinical outcomes have recently been reported in a series of 29 patients. 18 Meanwhile, Wood et al 19 have recently published another anatomic PLC technique using an isolated ST autograft that reproduces the FCL and PLT with the native ST graft diameter. However, inadequate asymmetrical strands of the ST tendon mounted onto a large fixation suspensory device (when retrograde drilling is not used) could be a potential pitfall.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Posterolateral Corner Reconstruction Using Semitendinosus and Gracilis Autografts: Surgical Technique

Pache¹,

Sienra²,

Larroque³

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

An anatomically based posterolateral corner (PLC) reconstruction has emerged as a viable and clinically effective surgical technique for midsubstance ligamentous injuries in both the acute and chronic settings. There are several surgical techniques for PLC reconstruction; however, the classic anatomic reconstruction technique (LaPrade technique) is now considered the gold standard and was originally described using an Achilles tendon allograft. In this article, we describe a modified LaPrade autograft technique, in which the same tunnel position, graft passage, and fixation are used to reproduce the 3 primary stabilizers of the PLC. Instead of allografts, hamstring autografts are used while tunnel diameters and fixation devices are adapted to them. With the use of autograft tendons, difficulties related to graft length or asymmetry are encountered. We consider this technique a good alternative for an anatomically based PLC reconstruction, especially given the lower availability and higher cost of allograft tissues in several countries.

show abstract

Section: Discussionmentioning

confidence: 99%

Anatomic Posterolateral Corner Reconstruction Using Semitendinosus and Gracilis Autografts: Surgical Technique

Pache¹,

Sienra²,

Larroque³

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…[21,43] Recently, newer anatomic reconstruction techniques have been described utilizing a single autograft, either semitendinosus or peroneus longus. [44,45] However, biomechanical and clinical testing is required to validate these methods.…”

Section: Lateral Collateral Ligament (Lcl) and Plcmentioning

confidence: 99%

Advances and trends in multiligament injuries of the knee relevant to low-resource settings

Held

North

Bormann

et al. 2020

JASSM

View full text Add to dashboard Cite

Recent advances in the management of multiligament knee injuries have led to improvements in diagnosis and management and allowed enhanced understanding of the biomechanics of ligament reconstructions. Most studies arise from subspecialist knee centers in high-income countries and can inform global strategies, but each patient encounter and environment is unique and not all recommendations may be feasible in every setting. For ligamentous injuries, the gold standard is acute arthroscopic, single-stage ligament reconstruction, although this is not always possible in the limited resource setting (LRS). For these circumstances, non-operative management, although rarely promoted, may be preferred in selected patients. Furthermore, acute surgery relies on adequate post-operative physiotherapy, otherwise a delayed surgical approach should be considered. Reconstruction remains the gold standard, but acute repair is an option for medial collateral and posterior cruciate ligaments and for avulsion fractures. For a vascular examination, a careful clinical assessment and routine angiography should be done in LRS. Due to the heterogeneity of injury and patient profile, outcomes vary widely and need to be interpreted in the context of the surgical setup. The main complications of these injuries are stiffness, residual laxity, and surgical site infections. Future trends will need to include a global perspective and provide solutions for surgeons in various parts of the world.

show abstract

“…24 One or more of the authors has declared the following potential conflict of interest or source of funding: This study was sponsored through a research grant by Smith & Nephew. A.M.G.…”

mentioning

confidence: 99%

Biomechanical Assessment of Knee Laxity After a Novel Posterolateral Corner Reconstruction Technique

et al. 2022

View full text Add to dashboard Cite

Background: Different techniques to restore knee stability after posterolateral corner (PLC) injury have been described. The original anatomic PLC reconstruction uses 2 separate allografts to reconstruct the PLC. Access to allograft tissue continues to be a significant limitation of this technique, which led to the development of a modified anatomic approach utilizing a single autologous semitendinosus graft fixed on the tibia with an adjustable suspensory loop to enable differential tensioning of the PLC components. Purpose/Hypothesis: The purpose of this study was to compare the modified anatomic technique with the original anatomic reconstruction in terms of varus and external rotatory laxity in a cadaveric biomechanical model. The hypothesis was that both techniques would restore varus and external rotatory laxity after a simulated complete PLC injury. Study Design: Controlled laboratory study. Methods: Eight pairs of fresh-frozen cadaveric knee specimens were tested to compare the 2 techniques. Varus and external tibial rotation laxity of the knee were measured while applying 10-N·m varus and 5-N·m external rotatory torques at 0°, 30°, 60°, and 90° of flexion. These measurements were tested under 3 conditions: (1) intact fibular collateral ligament, popliteal tendon, and popliteofibular ligament; (2) complete transection of the fibular collateral ligament, popliteal tendon, and popliteofibular ligament; (3) after PLC reconstruction with either the modified (n = 8) or the original (n = 8) technique. Results: After PLC reconstruction, varus laxity was restored with no statistically significant differences from the intact condition after both reconstruction techniques. Similar outcomes were observed for external rotation in extension; however, in terms of the external rotation limit with respect to the intact joint, significant reductions of mean ± SD 4.1°± 6.3° ( P = .036) and 5.1°± 6.6° ( P = .016) were recorded with the modified technique at 60° and 90° of flexion, respectively. No significant effect was observed on the neutral flexion kinematics from 0° to 90° of flexion, and no significant differences were observed between reconstructions ( P = .222). Conclusion: Both PLC reconstruction techniques restored the normal native varus as compared with the intact knee. Although the modified technique constrained end-range external rotation at 60° and 90° of flexion, no differences were noted with neutral flexion kinematics. Care should be taken when tensioning in the modified technique so that the tibia is in a neutral position to avoid overconstraining the knee. Clinical Relevance: The modified technique may prove useful in situations where there are limited graft options, particularly where allografts are not available or are restricted.

show abstract

Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device

Cited by 17 publications

References 17 publications

Anatomic Posterolateral Corner Reconstruction Using Semitendinosus and Gracilis Autografts: Surgical Technique

Anatomic Posterolateral Corner Reconstruction Using Semitendinosus and Gracilis Autografts: Surgical Technique

Advances and trends in multiligament injuries of the knee relevant to low-resource settings

Biomechanical Assessment of Knee Laxity After a Novel Posterolateral Corner Reconstruction Technique

Contact Info

Product

Resources

About