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Anatomical reconstruction of posterolateral corner and combined injuries of the knee

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The goal of this study was to present a 2- to 5-year prospective follow-up of an anatomical posterolateral corner reconstruction in a series of 16 patients with symptomatic instability and pain complaints of the knee.

Methods

All 16 patients underwent a posterolateral corner reconstruction as described by LaPrade et al. If cruciate ligament ruptures were present and had not been addressed earlier, these were reconstructed as well. Preoperatively and 2–5 years after surgery, multiple subjective knee outcome scores (VAS satisfaction score, Tegner, Lysholm, Noyes score and IKDC subjective knee form) were obtained, and the laxity of the joint was evaluated objectively by using bilateral varus stress radiographs to compare the injured with the uninjured knee.

Results

Eleven patients had concomitant ACL or PCL surgery or already had undergone surgery on this cruciate ligament. Mean varus laxity of the injured knee on varus stress radiographs improved significantly from 9.6° (6.6–17.1) to 6.3° (0.3–13.4), p = 0.0011. Post-operative varus laxity did not return to the level of the uninjured knee: 4.4° (1.5–7.7), p = 0.036. VAS satisfaction score, the Tegner, Lysholm, Noyes scores and the IKDC subjective knee form all improved significantly.

Conclusion

The anatomical reconstruction of the posterolateral corner does provide restoration of the external rotation stability in the majority of patients. However, the varus laxity could not be restored in all patients. Functional knee scores improved significantly, and most reconstructed knees had a laxity of <3° compared with the uninjured knee, but the reconstructed knee did not become as stable as the uninjured knee. The results of this study can assist surgeons and patients to have realistic expectations of this operation.

Level of evidence

Case series with no comparative group, Level IV.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands

    W. A. van der Wal, T. G. van Tienen, V. J. Busch & A. B. Wymenga

  2. Department of Research, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands

    P. J. C. Heesterbeek

  3. Department of Orthopaedic Surgery, Kliniek ViaSana Mill, Mill, The Netherlands

    T. G. van Tienen

  4. Department of Orthopaedic Surgery, LVR Klinik für Orthopädie, Viersen, Germany

    J. H. M. van Ochten

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  1. W. A. van der Wal
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  2. P. J. C. Heesterbeek
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  3. T. G. van Tienen
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  4. V. J. Busch
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  5. J. H. M. van Ochten
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  6. A. B. Wymenga
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Correspondence to W. A. van der Wal.

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van der Wal, W.A., Heesterbeek, P.J.C., van Tienen, T.G. et al. Anatomical reconstruction of posterolateral corner and combined injuries of the knee. Knee Surg Sports Traumatol Arthrosc 24, 221–228 (2016). https://doi.org/10.1007/s00167-014-3369-7

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  • DOI: https://doi.org/10.1007/s00167-014-3369-7

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