Posterolateral Reconstruction of the Knee: Surgical Technique with 2 Grafts

Many aspects of the posterolateral corner (PLC) of the knee have been extensively studied within the past 20 years. Quantitative anatomic and biomechanical studies have demonstrated the importance of the 3 static stabilizers of the lateral side of the knee: the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. Biomechanically, a 2-graft anatomic PLC reconstruction has been reported to restore varus and external rotational stability to the knee and clinical outcome studies have demonstrated that the anatomic technique leads to improved patient outcomes. A 2-graft anatomic PLC reconstruction also allows passive range of motion exercises early in the postoperative rehabilitation program, decreasing the risk of postoperative arthrofibrosis without compromising clinical results. This article presents a summary of the biomechanical basis of a 2-graft anatomic PLC reconstruction and provides a degraft description of the surgical technique. Additionally, a description of the postoperative rehabilitation program is presented and clinical outcomes of treating acute and chronic PLC injuries are summarized.