title: Comparison of Anatomic Posterolateral Knee Reconstruction Using 2 Different Popliteofibular Ligament Techniques.
abstract: BACKGROUND
  Anatomic posterolateral knee reconstruction is a surgical procedure that reconstructs the lateral collateral ligament (LCL), the popliteus tendon, and the popliteofibular ligament (PFL). Until recently, diverse techniques have been reported for this reconstruction; however, the gold standard is still a matter of debate.
  
  
  OBJECTIVE
  Clinical outcomes and stability with tibiofibular-based PFL reconstruction would be better than those with femorofibular-based PFL reconstruction.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  The records of 10 patients who underwent anatomic posterolateral knee reconstruction between January 2011 and December 2012 (LCL, popliteus tendon, tibiofibular-based PFL reconstruction [group A]) with a minimum follow-up of 24 months were retrospectively reviewed. Ten patients who underwent anatomic posterolateral knee reconstruction (LCL, popliteus tendon, femorofibular-based PFL reconstruction [group B]) using a split Achilles tendon allograft were recruited into a matched control group. All patients in both groups had an associate posterior cruciate ligament (PCL) injury, and 8 in each group underwent concomitant PCL reconstruction. Clinical outcomes were evaluated with International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scale scores. Knee stability was assessed with the dial test for the evaluation of external rotation as well as varus and posterior instability by stress radiography.
  
  
  RESULTS
  The mean (±SD) follow-up period was 29.5 ± 3.8 months in group A and 60.4 ± 33.8 months in group B. There were no clinically significant between-group differences in IKDC subjective scores (group A: 83.8 ± 5.4, group B: 82.7 ± 6.5; P = .853), Lysholm scores (group A: 83.4 ± 5.1, group B: 84.1 ± 7.3; P = .853), or Tegner activity scale scores (group A: 4.8 ± 1.4, group B: 4.2 ± 0.9; P = .436) at the final follow-up. In addition, there was no difference in side-to-side measurements on varus stress radiography (group A: 0.9 ± 0.7 mm, group B: 1.3 ± 1.2 mm; P = .481) or posterior stress radiography (group A: 5.3 ± 1.9 mm, group B: 5.4 ± 2.2 mm; P = .971) at the final follow-up. Although the external rotation grade of the tibia was not significantly different between groups preoperatively (P = .709), it was smaller in group A at the final follow-up (P = .044).
  
  
  CONCLUSIONS
  There were no significant differences in clinical outcomes or varus stability between the 2 techniques of PFL reconstruction in patients with posterolateral corner injuries who underwent anatomic posterolateral knee reconstruction. However, the external rotation grade of the tibia was smaller in the group that underwent tibiofibular-based PFL reconstruction.
authors: Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Korea.
authors: Kyoung Ho
authors: KH
authors: Yoon
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: Sang Hak
authors: SH
authors: Lee
authors: Department of Physical Education, Graduate School of Education, Yongin University, Yongin, Korea.
authors: Soo Yeon
authors: SY
authors: Park
authors: Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Korea.
authors: Sang Eon
authors: SE
authors: Park
authors: Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Korea taktakta@hanmail.net.
authors: Dae Hyun
authors: DH
authors: Tak
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D064591:Allografts; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D063868:Patient Outcome Assessment; D012189:Retrospective Studies
keywords: popliteofibular ligament; posterolateral knee reconstruction; posterolateral rotatory instability