Surgical Management of ACL, PCL, and Lateral-Sided Injuries: Acute and Chronic

  • Peter B. MacDonaldEmail author
  • Scott W. Mollison


Although rare, multi-ligament injuries to the knee pose great challenges to both patients and treating surgeons. Historically, these injuries were treated non-operatively with bracing and gradual rehabilitation to regain motion once the knee had become stiff and stable. Higher patient and surgeon expectations, together with advancing reconstruction techniques and a high failure rate with surgical repair alone, have led a shift toward surgical management with ligament reconstruction (Geeslin et al., Am J Sport Med. 44:1336–1342, 2015 [5]. The goals of surgical intervention are to provide the patient with a stable, well-aligned knee that allows for ambulation. In the treatment of these complex injuries involving the ACL, PCL, and postero-lateral structures, many unanswered questions still remain. The optimal timing of surgery, repair versus reconstruction, alignment, and graft choice will be addressed briefly in this chapter; however, the goal of this section will be to focus on surgical technique for repairing and reconstructing the knee with an acute and chronic combined ACL, PCL, and PLC injury.


Multiligament Knee dislocation ACL PCL Posterolateral corner Reconstruction Graft Acute Chronic Technique guide Allograft Autograft Fixation Tunnels 



Anterior cruciate ligament


Posterior cruciate ligament


Posterolateral corner










Anterolateral ligament


Iliotibial band


Popliteus muscle


Popliteo-fibular ligament


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Orthopedic Surgery, Pan Am ClinicUniversity of ManitobaWinnipegCanada

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