Anatomical Reconstruction of Knee Posterolateral Complex with the Tendon of the Long Head of Biceps Femoris

Abstract

Background There is no consensus about the best way to reconstruct the knee posterolateral complex. Hypothesis Anatomical reconstruction of the knee posterolateral complex with the tendon of the long head of biceps femoris can restore knee posterolateral stability. Study Design Case series; Level of evidence, 4. Methods Anatomical reconstruction of the fibular collateral ligament, popliteofibular ligament, and popliteus tendon was performed consecutively in 28 patients with chronic posterolateral knee injuries. Two distally pedicled tendon slips more than 16 cm long were created from the tendon of the long head of the biceps femoris. The posterior tendon slip was used to reconstruct the popliteofibular ligament and popliteus tendon, and the anterior slip were doubled to reconstruct the lateral collateral ligament. The patients were followed up for 2 to 4 years. Results At the latest follow-up, examinations showed that 96.4% (27/28) of the patients had a normal or nearly normal reconstructed fibular collateral ligament as judged by manual examination. All patients had a normal or nearly normal reconstructed popliteofibular ligament and popliteus tendon as judged by manual examination. Conclusion Anatomical reconstruction of the knee posterolateral complex with the tendon of the long head of biceps femoris is effective in restoring knee posterolateral stability.