Anatomic Posterolateral Corner Reconstruction With Single Graft Tibial Socket Fixation

Abstract

Introduction: The posterolateral corner (PLC) is comprised of the fibular collateral ligament, popliteus tendon, and popliteofibular ligament. Injuries to the PLC are associated with significant morbidity and functional limitation, most frequently manifested through a varus thrust gait. In the previous 2 decades, advances have been made in understanding the importance of the PLC and as a result, many techniques have been developed to address its reconstruction. Material and Methods: The Laprade technique is a previously described anatomic reconstruction of the PLC. We propose some modifications to this technique, which involve dissection of the posterolateral tibia to allow direct protection of the popliteal neurovascular bundle while establishing tibial fixation. A single hamstring graft is utilized for the reconstruction, is routed through the fibular tunnel and subsequently secured with the use of a dual-expanding tenodesis anchor, placed in a tibial socket removing the need for a tibial tunnel. Conclusion: The present study describes a novel anatomic technique that allows for improved protection of neurovascular structures, better control of graft tensioning and tunnel management, and the judicious use of a single tendon autograft while maintaining the described benefits of the anatomic Laprade technique.