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

• Published in: Archives of orthopaedic and trauma surgery Vol. 143; no. 9; pp. 5767 - 5776
• Main Authors: Helal, Ahmed, Marei, Abdelhakim E., Shafik, Ahmed, Elforse, Elsayed
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2023; Springer Nature B.V
• Subjects: Archives & records; Arthroscopy and Sports Medicine; Joint and ligament injuries; Knee; Medicine; Medicine & Public Health; Orthopedics; Patients; Surgery; Trauma; Multiligament knee injury; Posterolateral corner injury; Posterior cruciate ligament; Knee dislocation; Anterior cruciate ligament
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-023-04862-6

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).