Comparison of 2 surgical techniques for reconstructing posterolateral corner of the knee: a cadaveric study evaluated by navigation system.
OBJECTIVE
This study aimed to evaluate the immediate effect on knee kinematics by 2 different techniques of posterolateral corner (PLC) reconstruction.


METHODS
Five intact formalin-preserved cadaveric knees were used in this study. A navigation system was used to measure knee kinematics (posterior translation, varus angulation, and external rotation) after application of a constant force and torque to the tibia. Four different conditions of the knee were evaluated during the biomechanical test: intact knee and PLC-sectioned knee and PLC-reconstructed knee by the double-femoral tunnel technique and single-femoral tunnel technique.


RESULTS
Sectioning of the PLC structures resulted in significant increases in external rotation at 30° of flexion from 11.2° (SD, 2.6) to 24.6° (SD, 6.2), posterior translation at 30° of flexion from 3.4 mm (SD, 1.5) to 7.4 mm (SD, 3.8), and varus angulation at 0° of flexion from 2.3° (SD, 2.1) to 7.9° (SD, 5.1). Both reconstruction techniques significantly restored the varus stability. The external rotation and posterior translation at 30° of flexion after reconstruction with the double-femoral tunnel technique were 10.2° (SD, 1.3) and 3.4° (SD, 2.7), respectively, which were significantly better than those of the single-femoral tunnel technique.


CONCLUSIONS
Both techniques of reconstruction showed improved stability compared with PLC-sectioned knees. The double-femoral tunnel technique in PLC reconstruction showed better rotational stability and resistance to posterior translation than the single-femoral tunnel technique without compromising varus stability.


CONCLUSIONS
PLC reconstruction by a double-femoral tunnel technique achieves better rotational control and resistance to posterior translation.
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Eric Po-Yan
EP
Ho
Mak-Ham
MH
Lam
Mandy Man-Ling
MM
Chung
Daniel Tik-Pui
DT
Fong
Billy Kan-Yip
BK
Law
Patrick Shu-Hang
PS
Yung
Wood-Yee
WY
Chan
Kai-Ming
KM
Chan
D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D012399:Rotation; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*