Results of isolated posterolateral corner reconstruction

Isolated posterolateral corner (PLC) tears are relatively rare events. Various surgical techniques to treat posterolateral knee instability have been described; because surgical results are linked to cruciate reconstructions it has been difficult to date to define whether one surgical procedure has better prognosis than another. The goal of this study is to determine the clinical outcome of PLC reconstruction following fibular-based technique.

We retrospectively evaluated a case series of patients who received isolated PLC reconstruction between March 2005 and January 2007. Ten patients were surgically treated for isolated injuries and were available for follow-up; average patient age was 27.4 years (range 16–47 years). All patients were treated following the fibular-based technique: double femoral tunnel was performed in six patients, while in the remaining four patients, the reconstruction of the PLC was performed with a single femoral tunnel. Six patients had semitendinosus allograft and four had semitendinosus autograft. All patients had the same evaluation and the same rehabilitation protocol.

Mean follow-up was 27.5 months (range 18–40 months). Mean range of motion (ROM) was 143.5° for flexion (range 135–150°) and 0.5° for extension (range 0–3°). Three patients showed 1+ on varus stress test, while on Dial test another three patients showed 10° reduction of external rotation compared with contralateral knee. The average Lysholm score was 94 points (range 83–100), and the mean International Knee Documentation Committee (IKDC) subjective result was 88.48 (range 74–96.5). Based on Lysholm score, the results were excellent in eight knees and good in two knees. On IKDC evaluation, two patients were grade A and eight were grade B. No significant difference in clinical results was observed between single and double femoral tunnel.

Fibular-based technique showed good results in terms of clinical outcome, restoring varus and rotation stability of knees in treatment of chronic isolated PLC injury.