Single Soft Tissue Graft Reconstruction of the Fibular Collateral Ligament and Posterolateral Corner (SS-48)

Abstract

We report outcomes of a new technique utilizing a single soft tissue graft for FCL and posterolateral corner reconstruction, followed by a posterolateral capsular shift. Our technique takes into account the three main static posterolateral corner stabilizers (popliteofibular ligament, fibular collateral ligament, and posterolateral capsule). 19 knees in 19 patients were identified. Average follow-up was 19 months (range 12-29 months). Mean IKDC subjective score was 67, mean Lysholm score was 76. Complications included manipulation in two patients, and superficial wound infection requiring antibiotics in one patient. Only one patient has required revision reconstruction. Our series demonstrated satisfactory clinical and functional results. The purpose of this study is to present the functional and clinical outcomes of a consecutive series of patients who underwent fibular collateral ligament (FCL) and posterolateral corner reconstruction (PLC) utilizing a single soft tissue allograft construct. All patients were identified through our prospective sports medicine database. Only patients who had undergone FCL and PLC reconstruction (as opposed to repair) were included. All patients underwent identical surgical technique and followed a standard postoperative rehabilitation protocol. Functional and clinical outcomes were assessed utilizing physical exam, Lysholm scores, and International Knee Documentation Committee (IKDC) subjective scores. Between August 2004 and September 2006, 19 knees in 19 patients were identified. There were 16 males and 3 females. Average age was 28 years (range 20 to 61 years). All patients were followed for a minimum of 1 year with a mean clinical follow-up of 19 months (range 12-29 months). All patients sustained injuries to other ligaments in addition to the posterolateral corner. In total, there were 16 anterior cruciate ligament injuries, 13 posterior cruciate ligament injuries, and 4 posteromedial corner injuries which required reconstruction. Mean IKDC subjective score was 67 (range 24-99), and mean Lysholm score was 76 (range 38-99). Average knee range of motion was 104 degrees (range 80-150 degrees). Complications included stiffness requiring manipulation in two patients, and superficial wound infection requiring antibiotics in one patient. One posterolateral corner reconstruction has required revision to date. Numerous posterolateral corner techniques have been reported in the literature with varying degrees of success. We describe a technique that takes into account the three main static posterolateral corner stabilizers (popliteofibular ligament, fibular collateral ligament, and posterolateral capsule) which has not beenpreviously reported. Our series demonstrated satisfactory clinical and functional outcomes.