Posterolateral reconstruction using split achilles tendon allograft

Abstract 

Injury to the cruciate ligaments of the knee commonly occurs in association with posterolateral instability, which can cause severe functional disability including varus, posterior translation, and external rotational instability. Failure to diagnose and treat an injury of the posterolateral corner in a patient who has a tear of the cruciate ligament can also result in the failure of the reconstructed cruciate ligament. Unlike isolated posterior cruciate ligament injury, there seems to be a consensus of opinion that injury to the posterolateral corner, whether isolated or combined, is best treated by reconstructing the posterolateral corner along with the coexisting cruciate ligament injury, if combined. Commonly proposed methods of reconstructing the posterolateral corner have focused on the reconstruction of the popliteus, the popliteofibular ligament, and the lateral collateral ligament. We introduce a new technique for reconstructing the posterolateral corner using a split Achilles tendon allograft. Our method reasonably addresses the several pitfalls in the reconstruction of the posterolateral corner, including (1) concurrent reconstruction of important posterolateral structures, (2) regaining the isometry of the lateral collateral ligament, (3) repositioning the reconstructed popliteus into its original position, and (4) providing a secure fixation method.

Keywords:  Posterolateral, Reconstruction, Achilles tendon, Allograft