title: Anatomic Posterolateral Corner Reconstruction Using a Fibula Cross-Tunnel Technique: A Cadaveric Biomechanical Study.
abstract: To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees.
  
  
  
  Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion. Reconstruction was performed using 2 independent tendon autografts. Afterward, the fibula and graft were loaded to failure.
  
  
  
  Reconstruction restored external rotation (0°: 11.75° ± 2.02° to 9.81° ± 1.81°, P = .57; 30°: 17.91° ± 1.32° to 13.96° ± 2.84°, P = .12; 60°: 15.86° ± 1.68° to 13.26° ± 3.58°, P = .41; 90°: 15.53° ± 1.62° to 14.07° ± 2.95°, P = .54) to the intact state, and posterior translation (0°: 3.66 ± 0.85 mm to 3.31 ± 0.89 mm, P = .87; 60°: 3.15 ± 0.45 mm to 2.96 ± 0.45 mm, P = .73; 90°: 2.74 ± 0.33 mm to 3.05 ± 0.41 mm, P = .41) and varus angulation (0°: 0.92° ± 0.35° to 1.98° ± 0.42°, P = .55; 30°: 2.65° ± 0.27° to 1.09° ± 0.90°, P = .37; 90°: 4.29° ± 0.44° to 2.53° ± 1.13°, P = .19) under most conditions. During load to failure testing, the construct revealed properties similar to those of native structures (yield load: 330.4 ± 45.8 N; ultimate load: 420.9 ± 37.4 N).
  
  
  
  This technique restored external rotation to the intact state after PLC injury in all testing conditions, as well as posterior translation at 0°, 60°, and 90° of flexion, and varus angulation under all conditions tested except 60° of flexion.
  
  
  
  Clinically, this surgical technique may eliminate the need for a tibial tunnel for posterolateral corner reconstruction.
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.; Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Hideya
authors.initials: H
authors.lastname: Ishigooka
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.; Department of Orthopaedic Surgery, Stanford University, Redwood City, California, U.S.A.
authors.forename: Sean T
authors.initials: ST
authors.lastname: Campbell
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Quigley
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.
authors.forename: Michelle H
authors.initials: MH
authors.lastname: McGarry
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.
authors.forename: Yu Jen
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.
authors.forename: Akash
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.
authors.forename: Christopher N H
authors.initials: CNH
authors.lastname: Bui
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.. Electronic address: tqlee@med.va.gov.
authors.forename: Thay Q
authors.initials: TQ
authors.lastname: Lee
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002102:Cadaver; D005360:Fibula / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000502:physiology / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008875:Middle Aged; D016059:Range of Motion, Articular; D012399:Rotation; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous