Allograft Options in Posterolateral Corner Reconstructions

This article describes the indications, technique, and allograft rationale for reconstruction of the posterolateral corner injury. In chronic or nonreconstructable grade III posterolateral corner injuries, allograft reconstruction is the preferred technique. We prefer an anatomic reconstruction of the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. Our allograft of choice is achilles tendon with proximal bone attached. We believe that it is the most appropriate for two reasons. The first is length, 23 cm of allograft is needed to perform this reconstruction, and this allograft has ample length to perform this reconstruction. The second is strength; the achilles has more than 3 times the tensile strength of the gracilis and 2.5 times the tensile strength of semitendinosis. This allograft also allows for bony tunnels that are not overstuffed while also providing a bone to bone surface to heal.