title: Posterolateral corner reconstruction for posterolateral rotatory instability combined with posterior cruciate ligament injuries: comparison between fibular tunnel and tibial tunnel techniques.
abstract: The aim of this study was to compare the results of two different methods of posterolateral corner reconstruction (fibular head tunnel versus tibial tunnel), performed at the same time as a posterior cruciate ligament reconstruction. Between January 1999 and October 2003, 47 patients underwent tensioning of a remnant posterior cruciate ligament and anterolateral bundle reconstruction along with a posterolateral corner reconstruction using a fibular head bone or tibial bone tunnel. Thirty-nine patients determined to be eligible were enrolled in this retrospective study after a minimum follow-up duration of 2 years. The average duration of follow-up was 35.3 months (range 24-70 months). Satisfactory results were achieved in 32 patients (82%) according to the International Knee Documentation Committee(IKDC) scores, and 29 patients (74%) had restored external rotational stability. The fibular head tunnel was superior to the tibial tunnel method in terms of operation time (43.0 +/- 15.7 vs. 66.6 +/- 9.4 min, respectively, P < 0.001) and improved rotational stability (85 vs. 65%, respectively, P = 0.007). However, there were no significant differences seen in anteroposterior stability and clinical assessments [Orthopädische Arbeitsgruppe Knie (OAK) P = 0.277 and IKDC scores P = 0.564]. In grade 2 chronic posterolateral rotatory instability with little or no varus instability associated with injury to the posterior cruciate ligament, a posterolateral reconstructive procedure with a single sling through the fibular tunnel offers advantages of less surgical morbidity and operation time, as well as better rotational stability, over reconstruction through the tibial tunnel.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, Republic of Korea.
authors.forename: Young-Bok
authors.initials: YB
authors.lastname: Jung
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Jung
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Se-Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Kwang-Sup
authors.initials: KS
authors.lastname: Song
authors.forename: Yong Seuk
authors.initials: YS
authors.lastname: Lee
authors.forename: Sang-Hak
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D005360:Fibula / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000601:surgery*; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods*; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies