Abstract:

Objective：To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction, compared with an open popliteofibular ligament reconstruction. Methods: Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament. The patients were assessed for knee instability with use of the dial test at 30° and 90°, together with posterior stress radiography and KT-1000 measurement.  Results: The mean time of follow-up was more than 2 years. At the final follow-up evaluation, the tibial posterior translation as measured by stress radiography at 90° of knee flexion, the anterior-posterior translation as measured by KT-1000, and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001) in both groups. Between the two groups, the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014, P<0.001). But the other comparisons were not significantly different (P>0.05). The final flexion losses were 3.33°±4.88° and 3.06°±3.38° for the two groups. Conclusion: Combined with posterior cruciate ligament reconstruction, anatomical posterolateral corner reconstruction of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar outcomes. This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

Key words: Joint instability, Knee joint, Reconstructive surgical procedures, Tendons, Ligaments, articula