Clinical and radiological outcomes of a modified anatomic posterolateral corner reconstruction technique using a single semitendinosus autograft

Abstract

Purpose We aimed to assess the clinical and radiological outcomes of a modified anatomical posterolateral corner (PLC) reconstruction technique using a single autograft. Methods This prospective case series included 19 patients with a posterolateral corner injury. The posterolateral corner was reconstructed using a modified anatomical technique that utilized adjustable suspensory fixation on the tibial side. Patients were evaluated subjectively using the international knee documentation form (IKDC), Lysholm, and Tegner activity scales and objectively by measuring the tibial external rotation angle, knee hyperextension, and lateral joint line opening on stress varus radiographs before and after surgery. The patients were followed-up for a minimum of 2 years. Results Both IKDC and Lysholm knee scores significantly improved from 49 and 53 preoperatively to 77 and 81 postoperatively, respectively. The tibial external rotation angle and knee hyperextension showed significant reduction to normal values at the final follow-up. However, the lateral joint line opening measured on the varus stress radiograph remained larger than the contralateral normal knee. Conclusion Posterolateral corner reconstruction with a hamstring autograft using a modified anatomical reconstruction technique significantly improved both the subjective patient scores and objective knee stability. However, the varus stability was not completely restored compared with the uninjured knee. Level of evidence Prospective case series (Level of evidence IV).

Arthroscopic and open reconstruction of the posterolateral corner of the knee have equally good clinical results: first results of a prospective 12-month follow-up study

“…Arthrofibrosis is a commonly observed complication in multiligament knee injuries [ 36 ]. In this study, the incidence of arthrofibrosis was at 4% (1/26), which is comparable to other PLC-reconstructing studies [ 31 , 32 ].…”

“…The same study group compared arthroscopic and open reconstruction of the PLT in combination with PCL reconstruction and showed no difference in PROMS and stability between the two groups of patients (SSD of PTT 4 and 5 mm and ER of 1 and 3°) [ 31 ]. Recently, Helal et al [ 32 ] reported on a case series with a mean follow-up of 25 months. They found that 11 patients who underwent a reconstruction of the PLC and PCL had comparable results in external rotation (SSD of ER decreased from 16.7° to 3.5° postoperatively) and clinical outcomes (Lysholm/ IKDC 81/78 points).…”