Great Results 14 Years Later: Posterolateral Corner Reconstruction Technique

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Dr. Marx recently highlighted an article from the Knee Surgery, Sports Traumatology Arthroscopy (KSSTA) journal about a unique multi-ligament reconstruction technique. Known as the “single graft posterolateral corner (PLC) reconstruction technique,” this surgical method for repairing PLC injuries provides enhanced stability for the PLC compared with other similar techniques. In 2003, Dr. Marx and Dr. Levy, an orthopedic surgeon at Mayo Clinic, developed the single graft PLC reconstruction technique together. The study published in KSSTA this June shows great clinical results 14 years later.

The posterolateral corner (PLC) includes the back and outside of the knee. It is commonly injured along with the anterior cruciate ligament (ACL) and/or the posterior cruciate ligament (PCL) in multi-ligament knee injuries or knee dislocations. Surgical treatment of PLC injuries after sports injuries or other accidents can eliminate or decrease knee instability. Two ligaments, the fibular collateral ligament (FCL) and the popliteofibular ligament (PFL), as well as the popliteal tendon make up the PLC. Surgical procedures to correct knee instability due to PLC injury must compensate for all of the ligaments and tendons involved. The single graft technique uses just an achilles allograft to reconstruct the PLC. This technique is used when the patient’s own ligaments are unrepairable. An image from the study shows how one graft can mimic both the FCL and PFL by double insertion in both the femur and tibia, and crossing over in the lateral distal femur (see below). The study published in KSSTA this summer shows that patients who were treated with the single graft PLC reconstruction technique had good knee stability more than two years post-surgery

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Image copyright Mayo Clinic (Sanders et al. 2017)

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