Isometry of the Lateral Collateral and Popliteofibular Ligaments and Techniques for Reconstruction Using a Free Semitendinosus Tendon Graft

Injuries to the lateral and posterolateral aspects of the knee are likely more common than appreciated. If these injuries are not recognized and treated, they may result in suboptimal results when treating injuries to the anterior cruciate ligament and posterior cruciate ligament. The treatment options for injuries to the lateral and posterolateral structures include primary repairs, primary repairs with augmentation, tightening of existing structures, and the creation of structural restraints from the lateral femoral epicondyle to either the posterolateral tibia or the fibular head. Reconstructive procedures to the fibular head offer advantages over those to the posterolateral tibia in that they are more optimally positioned to resist varus and posterolateral rotations, and tissue from the epicondyle to the posterior aspect to the fibular head maintains near isometry through a functional range of knee motion. A free semintendinosus tendon graft can be used to reconstruct the lateral collateral ligament and popliteofibular ligaments with minimal morbidity. This procedure can be used as an isolated procedure or in combination with other reconstructive procedures or primary repairs.