J Knee Surg 2015; 28(06): 471-474
DOI: 10.1055/s-0035-1558857
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes of Surgical Treatment of Posterolateral Instability of the Knee

Elad Spitzer
1   Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
,
John B. Doyle
1   Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
,
Robert G. Marx
1   Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
2   Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York
› Author Affiliations
Further Information

Publication History

16 April 2015

26 May 2015

Publication Date:
12 August 2015 (online)

Abstract

The purpose of this review is to assess the outcomes of surgical treatment of posterolateral instability of the knee in an evidence-based manner. The majority of the existing outcomes literature on posterolateral instability consists of small, level IV case series and level III retrospective studies. Outcomes of surgical treatment of posterolateral instability of the knee are difficult to compare because of the heterogeneous presentation of posterolateral corner (PLC) injuries, the variability of their associated injuries, and their relative rarity. As such, three common types of surgical intervention for posterolateral instability are explored separately in this article, including acute repair, acute reconstruction, and chronic reconstruction. In general, the current literature supports early anatomic repair of all soft tissues and concomitant PLC reconstruction; however, because of the variability of posterolateral injury, surgical treatment options should be tailored to the patient, depending on the severity and chronicity of the posterolateral instability, as well as the associated injuries present.

 
  • References

  • 1 Baker Jr CL, Norwood LA, Hughston JC. Acute posterolateral rotatory instability of the knee. J Bone Joint Surg Am 1983; 65 (5) 614-618
  • 2 Covey DC. Injuries of the posterolateral corner of the knee. J Bone Joint Surg Am 2001; 83A (1) 106-118
  • 3 DeLee JC, Riley MB, Rockwood Jr CA. Acute posterolateral rotatory instability of the knee. Am J Sports Med 1983; 11 (4) 199-207
  • 4 Lee MC, Park YK, Lee SH, Jo H, Seong SC. Posterolateral reconstruction using split Achilles tendon allograft. Arthroscopy 2003; 19 (9) 1043-1049
  • 5 Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am 1977; 59 (2) 236-239
  • 6 Welling RE, Kakkasseril J, Cranley JJ. Complete dislocations of the knee with popliteal vascular injury. J Trauma 1981; 21 (6) 450-453
  • 7 Sisto DJ, Warren RF. Complete knee dislocation. A follow-up study of operative treatment. Clin Orthop Relat Res 1985; (198) 94-101
  • 8 Almekinders LC, Logan TC. Results following treatment of traumatic dislocations of the knee joint. Clin Orthop Relat Res 1992; (284) 203-207
  • 9 Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am 1963; 45 (5) 889-904
  • 10 Meyers MH, Moore TM, Harvey Jr JP. Traumatic dislocation of the knee joint. J Bone Joint Surg Am 1975; 57 (3) 430-433
  • 11 Shapiro MS, Freedman EL. Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation. Am J Sports Med 1995; 23 (5) 580-587
  • 12 Wright DG, Covey DC, Born CT, Sadasivan KK. Open dislocation of the knee. J Orthop Trauma 1995; 9 (2) 135-140
  • 13 Pacheco RJ, Ayre CA, Bollen SR. Posterolateral corner injuries of the knee: a serious injury commonly missed. J Bone Joint Surg Br 2011; 93 (2) 194-197
  • 14 Shelbourne KD, Haro MS, Gray T. Knee dislocation with lateral side injury: results of an en masse surgical repair technique of the lateral side. Am J Sports Med 2007; 35 (7) 1105-1116
  • 15 Veltri DM, Warren RF. Operative treatment of posterolateral instability of the knee. Clin Sports Med 1994; 13 (3) 615-627
  • 16 Krukhaug Y, Mølster A, Rodt A, Strand T. Lateral ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc 1998; 6 (1) 21-25
  • 17 Geeslin AG, LaPrade RF. Outcomes of treatment of acute grade-III isolated and combined posterolateral knee injuries: a prospective case series and surgical technique. J Bone Joint Surg Am 2011; 93 (18) 1672-1683
  • 18 Baker Jr CL, Norwood LA, Hughston JC. Acute combined posterior cruciate and posterolateral instability of the knee. Am J Sports Med 1984; 12 (3) 204-208
  • 19 Levy BA, Dajani KA, Morgan JA, Shah JP, Dahm DL, Stuart MJ. Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med 2010; 38 (4) 804-809
  • 20 Stannard JP, Brown SL, Farris RC, McGwin Jr G, Volgas DA. The posterolateral corner of the knee: repair versus reconstruction. Am J Sports Med 2005; 33 (6) 881-888
  • 21 Ibrahim SAR, Ghafar S, Salah M , et al. Surgical management of traumatic knee dislocation with posterolateral corner injury. Arthroscopy 2013; 29 (4) 733-741
  • 22 Lee BI, Kwon SW, Kim JB, Choi HS, Min KD. Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft. Arthroscopy 2008; 24 (5) 560-568
  • 23 Noyes FR, Barber-Westin SD. Surgical reconstruction of severe chronic posterolateral complex injuries of the knee using allograft tissues. Am J Sports Med 1995; 23 (1) 2-12
  • 24 Schechinger SJ, Levy BA, Dajani KA, Shah JP, Herrera DA, Marx RG. Achilles tendon allograft reconstruction of the fibular collateral ligament and posterolateral corner. Arthroscopy 2009; 25 (3) 232-242
  • 25 Wajsfisz A, Christel P, Djian P. Does combined posterior cruciate ligament and posterolateral corner reconstruction for chronic posterior and posterolateral instability restore normal knee function?. Orthop Traumatol Surg Res 2010; 96 (4) 394-399
  • 26 Larson R, Sides J, Beals T. Isometry of the lateral collateral and popliteofibular ligaments and a technique for reconstruction. University of Washington, Research Report; 1996: 42-44
  • 27 Khanduja V, Somayaji HS, Harnett P, Utukuri M, Dowd GS. Combined reconstruction of chronic posterior cruciate ligament and posterolateral corner deficiency. A two- to nine-year follow-up study. J Bone Joint Surg Br 2006; 88 (9) 1169-1172
  • 28 Rios CG, Leger RR, Cote MP, Yang C, Arciero RA. Posterolateral corner reconstruction of the knee: evaluation of a technique with clinical outcomes and stress radiography. Am J Sports Med 2010; 38 (8) 1564-1574
  • 29 Zorzi C, Alam M, Iacono V, Madonna V, Rosa D, Maffulli N. Combined PCL and PLC reconstruction in chronic posterolateral instability. Knee Surg Sports Traumatol Arthrosc 2013; 21 (5) 1036-1042
  • 30 Lee SH, Jung YB, Jung HJ, Song KS, Ko YB. Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc 2010; 18 (9) 1219-1225
  • 31 Stannard JP, Brown SL, Robinson JT, McGwin Jr G, Volgas DA. Reconstruction of the posterolateral corner of the knee. Arthroscopy 2005; 21 (9) 1051-1059
  • 32 LaPrade RF, Johansen S, Wentorf FA, Engebretsen L, Esterberg JL, Tso A. An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique. Am J Sports Med 2004; 32 (6) 1405-1414
  • 33 LaPrade RF, Johansen S, Agel J, Risberg MA, Moksnes H, Engebretsen L. Outcomes of an anatomic posterolateral knee reconstruction. J Bone Joint Surg Am 2010; 92 (1) 16-22
  • 34 Kim S-J, Kim T-W, Kim S-G, Kim HP, Chun YM. Clinical comparisons of the anatomical reconstruction and modified biceps rerouting technique for chronic posterolateral instability combined with posterior cruciate ligament reconstruction. J Bone Joint Surg Am 2011; 93 (9) 809-818
  • 35 Nau T, Chevalier Y, Hagemeister N, Deguise JA, Duval N. Comparison of 2 surgical techniques of posterolateral corner reconstruction of the knee. Am J Sports Med 2005; 33 (12) 1838-1845