title: Anatomical reconstruction of posterolateral corner and combined injuries of the knee.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Case series with no comparative group, Level IV.
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands. wybrenvanderwal@gmail.com.
authors.forename: W A
authors.initials: WA
authors.lastname: van der Wal
authors.affiliation: Department of Research, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands.
authors.forename: P J C
authors.initials: PJ
authors.lastname: Heesterbeek
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands.|Department of Orthopaedic Surgery, Kliniek ViaSana Mill, Mill, The Netherlands.
authors.forename: T G
authors.initials: TG
authors.lastname: van Tienen
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands.
authors.forename: V J
authors.initials: VJ
authors.lastname: Busch
authors.affiliation: Department of Orthopaedic Surgery, LVR Klinik für Orthopädie, Viersen, Germany.
authors.forename: J H M
authors.initials: JH
authors.lastname: van Ochten
authors.affiliation: Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands.
authors.forename: A B
authors.initials: AB
authors.lastname: Wymenga
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007717:Knee / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012086:Reoperation; D055815:Young Adult
keywords: Knee; Multiligament; Posterolateral corner; Stress radiographs