Outcomes following anatomic fibular (lateral) collateral ligament reconstruction

Moulton, Samuel G.; Matheny, Lauren M.; James, Evan W.; LaPrade, Robert F.

doi:10.1007/s00167-015-3634-4

Cited by 30 publications

(24 citation statements)

References 36 publications

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“…21,22 The graft is fixed at 20 to 30 because biomechanical studies have shown that these are the angles at which the greatest amount of varus instability is created by sectioning the FCL. 2,7,15 Coobs et al 15 biomechanically showed that anatomical FCL reconstruction restores varus, external, and internal rotation to near normal stability to knees with isolated FCL injuries.…”

Section: Discussionmentioning

confidence: 99%

“…21 Another study on anatomic FCL reconstruction showed significant preoperative to postoperative improvements in mean Lysholm and Western Ontario and McMaster Universities Arthritis Index scores, the median SF-12 physical component subscale score and postoperative patient reported outcome scores at an average of 2.7 years postoperatively. 22 The semitendinosus tendon is preferred because it is long enough to match the length of the FCL, which has shown to be 70 mm on average. 18 The graft is also preferred because of its tensile strength and larger size.…”

Section: Discussionmentioning

confidence: 99%

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Anatomic Fibular Collateral Ligament Reconstruction

Moatshe

Dean

Chahla

et al. 2016

Arthroscopy Techniques

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Fibular collateral ligament (FCL) injuries can lead to varus instability of the knee, causing a varus thrust gait and resulting in increased forces on the medial compartment of the knee. In the long term, this can result in meniscal injuries and medial compartment osteoarthritis. Varus instability is also reported to increase forces on the cruciate ligaments, which can lead to overload and failure of these reconstructions in cases of nonrecognized combined injuries. Historically, both repair and reconstruction have been used for grade III injuries to the FCL. However, repair has been reported to lead to a higher reoperation rate. The hereby presented reconstruction technique is used for FCL injuries that do not involve other structures of the posterolateral corner, but can be used in combination with other knee ligament reconstructions including the posterior cruciate ligament, anterior cruciate ligament, and medial collateral ligament. The purpose of this surgical technique article was to describe the biomechanically validated anatomic reconstruction of the FCL using a semitendinosus graft.T he fibular collateral ligament (FCL) is an important stabilizer of the lateral side of the knee through the whole range of motion. Likewise, it resists external rotation near full extension.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomic Fibular Collateral Ligament Reconstruction

Moatshe

Dean

Chahla

et al. 2016

Arthroscopy Techniques

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“…In all of these cases, our clinical outcome studies of our novel anatomic-based reconstructions have helped to redefine the ceiling levels of what is expected for both clinical and objective outcomes. 3,8,9,12,[27][28][29] Vail, Colorado (R.F.L.) and University of Oslo (L.E.).…”

Section: See Related Article On Page 2487mentioning

confidence: 99%

“…9 Further follow-up on a case series of 43 patients found similar outcomes, with a mean Lysholm score of 84. 12 Finally, because of the encouraging objective outcomes found in these patients, we have recently performed a prospective Level I study on 36 patients with either a standard nonweightbearing or early weightbearing protocol, and found that early partial weightbearing immediately after surgery did not result in any objective differences in the varus stress radiographs. 15 In addition, the early partial weightbearing patients had improved early outcomes with fewer effusions and improved quadriceps strength.…”

Section: See Related Article On Page 2487mentioning

confidence: 99%

Editorial Commentary: Small Incisions Can Make Big Mistakes: Knee Lateral Collateral Ligament Reconstruction Is All About the Anatomy!

LaPrade¹,

Engebretsen

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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It is becoming increasingly recognized that isolated lateral collateral ligament (LCL) tears are more common than have been previously recognized and that anatomic-based LCL reconstructions have the best outcomes. Although it was believed that posterolateral corner injuries were often missed or mistreated and were given the pneumonic of "the dark side of the knee," we are getting to the point where most of these more severe injuries are being recognized, and it is the isolated LCL injuries that are still less well recognized. Failure to treat LCL tears at the same time as a cruciate ligament reconstruction is a well-known cause of both anterior cruciate ligament and posterior cruciate ligament reconstruction graft failure. Therefore, either having the required clinical experience or knowledge, or using a radiographic backup method when one is not sure about the anatomic placement, is essential to correctly perform an LCL reconstruction.

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“…These techniques are anatomically based and biomechanically validated, and successful outcomes have been reported. 20,29,30 Patients with chronic PLC injuries need long-leg alignment radiographs to evaluate for varus alignment and may first need to undergo a high tibial osteotomy as an index procedure to avoid premature PLC graft failure. 29,31 A split Achilles tendon allograft is utilized for a complete PLC reconstruction.…”

Section: Lateral Knee/posterolateral Cornermentioning

confidence: 99%

Ligamentous Reconstruction of the Knee: What Orthopaedic Surgeons Want Radiologists to Know

Geeslin

LaPrade

2017

Semin Musculoskelet Radiol

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Knee ligament injuries are common, and treatment methods are continually evolving. Accurate clinical diagnosis with imaging confirmation is critical to support appropriate treatment. Several imaging pearls allow for improved recognition of injuries. Stress radiographs may be obtained to quantify knee laxity. Magnetic resonance imaging allows assessment of the complex anatomy of the knee and has excellent sensitivity and specificity for many injuries.

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Outcomes following anatomic fibular (lateral) collateral ligament reconstruction

Abstract: Level IV.

Cited by 30 publications

References 36 publications

Anatomic Fibular Collateral Ligament Reconstruction

Anatomic Fibular Collateral Ligament Reconstruction

Editorial Commentary: Small Incisions Can Make Big Mistakes: Knee Lateral Collateral Ligament Reconstruction Is All About the Anatomy!

Ligamentous Reconstruction of the Knee: What Orthopaedic Surgeons Want Radiologists to Know

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