Minimally invasive anatomic posterolateral corner reconstruction with arthroscopic assistance in a left knee. Reconstruction in the acute setting is preferred, with anatomic-based, single-bundle anterior cruciate ligament reconstruction, double-bundle posterior cruciate ligament reconstruction, and anatomic reconstruction of the posterolateral corner using two grafts for the 3 primary posterolateral corner stabilizers. Over the last 30 years, our understanding of the posterolateral corner as well as its operative reconstruction evolved. Summary of Stages in Combined ACL and Posterolateral Corner Reconstruction Operative Step Summary Patient setup Supine with thigh tourniquet and knee flexed to 90 Side support and foot bolster PLC dissection (fibula) Posterior longitudinal incision over fibula head Tunnel drilled from anterolateral to Am J Sports Med. Anatomic Posterolateral Corner Knee Reconstruction Robert A. Arciero, M.D. 14. Short grafts may render combined reconstruction … a combined posterior drawer and external rotation force is then applied to the knee to assess for an increase in posterolateral translation (lateral tibia externally rotates relative to lateral femoral condyle) Basic science studies have helped us determine the 3 critical structures of the posterolateral corner: the lateral collateral ligament (LCL), the popliteus tendon, and the popliteofibular ligament. 18.1. To compare post-operative physical activity and return to work after combined posterolateral corner (PLC) reconstruction (PLC-R) in anterior cruciate ligament (ACL)- or posterior cruciate ligament (PCL)-based injuries. A retraction suture is temporarily placed around the popliteal tendon (PLT) tendon to facilitate maneuvering. Comparison of clinical results of anatomic posterolateral corner reconstruction for posterolateral rotatory instability of the knee with or without popliteal tendon reconstruction. Illustration depicting the anatomy of the posteromedial structures of the knee. However, the repairs shall be limited to specific situations and the concept of anatomic reconstructions must be scrutinized, as the indications … Minimally invasive anatomic posterolateral corner reconstruction with arthroscopic assistance in a left knee. The Y graft construct is prepared by looping the graft around a TightRope RT at 95 mm from the distal end. Do you want to switch? Posterolateral corner reconstruction in right knee: lateral view of fibular and tibial guide pin placement for subsequent tunnel reaming. (From [ 43 ]. Posterolateral corner (PLC) injury is thought to account for approximately 16% of acute injuries of the knee 4,5.It is often seen in sports-related injuries and mostly related to direct anteromedial tibial impact trauma, but is also caused by hyperextension and external rotation injuries, non-contact varus stress injuries, and anterior or posterior dislocations of the knee. At the beginning, an additional midlateral portal is created to achieve better access to the popliteal complex. This surgical approach is technically demanding, requiring proficiency with surgical dissection: This technique has been evaluated biomechanically and validated using patient reported outcome studies. 7. Abstract: This manuscript intends to review and discuss the current concepts of posterolateral corner (PLC) repair and reconstruction techniques. Posterolateral Corner Reconstruction; ArthroLab ... Arthrex GmbH ArthroLab Erwin-Hielscher-Str. The posterolateral corner (PLC) has been called many things, but it has never been described as simple or straightforward. SwiveLock & SwiveLock™ & FiberChain™ Knotless Rotator Cuff Repair FiberChain Knotless Rotator Cuff Repair Surgical Technique SwiveLock Designed in conjunction with Stephen S. Burkhart, M.D., San Antonio, TX. Systematic review flowchart following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. 1462 - 1469 CrossRef View Record in Scopus Google Scholar Patients aged > 18 years undergoing PLC-R using the Larson technique combined with either ACL or PCL reconstruction were included. Learn the Haglunds deformity correction; Arthrex Speedbridge technique surgical technique with step by step instructions on OrthOracle. Introduction Although open-surgical techniques for the reconstruction of the posterolateral corner (PLC) are well established, the use of arthroscopic procedures has recently increased. reconstruction. This evolution has attempted to refine what is an “anatomic” reconstruction. These will be tied near the conclusion of the case. Biomechanical comparisons between 4-strand and modified Larson 2-strand procedures for reconstruction of the posterolateral corner of the knee Am J Sports Med , 39 ( 7 ) ( 2011 ) , pp. Reprinted with permission from Thieme Publishers) For the initial posteromedial approach to the knee, the patient is positioned supine on a flat operating room … (A) Tibial fixation of the popliteus tendon (PLT) and popliteofibular ligament (PFL) grafts is performed at 60° of knee flexion and neutral rotation with a 7 × 23–mm bioabsorbable screw. Abstract: Injuries to the lateral collateral ligament and posterolateral corner of the knee, particularly when combined with anterior cruciate or posterior cruciate ligament injuries, can result in profound symptomatic knee instability. Combined PCL, Posteromedial Corner, and Posterolateral Corner Reconstruction. Our e-learning platform contains high resolution images and a certified CME of the Haglunds deformity correction; Arthrex Speedbridge technique surgical procedure. Reconstruction of the posterolateral corner of the knee has received increased attention in the recent literature. Posterolateral corner (PLC) injuries have historically been overlooked and frequently occur concurrently with cruciate ligament injuries. Table 2. At the beginning, an additional midlateral portal is created to achieve better access to the popliteal complex. Arthrex is easily accessible by car as well as by public transportation. This website is also available in your language! INTRODUCTION. posterolateral corner. These lesions commonly occur in association with other ligament injuries, making decisions regarding treatment challenging. Am J Sports Med 2000;28:32-39. Reconstruction of the Posterolateral Corner of the Knee With Achilles Tendon Allograft. Babak Samimi, MD, (Los Angeles, CA) discusses his technique for posterolateral corner reconstruction. Anatomic posterolateral corner reconstruction can be performed in both acute and chronic settings in appropriately indicated patients. (B) Final graft configuration of posterolateral corner reconstruction. Anatomic posterolateral corner reconstruction in left knee with autogenous peroneus longus Y graft construct. An untreated posterolateral corner (PLC) injury in patients with a torn anterior cruciate ligament (ACL) may be a leading cause of ACL reconstruction failure. Deficiency of the posterolateral structures as a cause of graft failure. Corner Repair and Reconstruction ... Background: Injuries to the posterolateral corner (PLC) may occur concurrently with anterior cruciate ligament (ACL) ... received educational support from Arthrex and Smith & Nephew and hospitality payments from Medical Device Business Systems. There are many different types of repair and reconstruction of the PLC.

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