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Anatomic Posterolateral Corner Reconstruction Using a Fibula Cross-Tunnel Technique: A Cadaveric Biomechanical Study
Journal article   Open access   Peer reviewed

Anatomic Posterolateral Corner Reconstruction Using a Fibula Cross-Tunnel Technique: A Cadaveric Biomechanical Study

Hideya Ishigooka, Sean T. Campbell, Ryan J. Quigley, Michelle H. McGarry, Yu Jen Chen, Akash Gupta, Christopher N.H. Bui and Thay Q. Lee
Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol.32(11)
2016

Abstract

Aged Biomechanical Phenomena Cadaver Fibula Humans Knee Injuries Knee Joint Ligaments, Articular Middle Aged Range of Motion, Articular Rotation Tendons Transplantation, Autologous adult aged Article biomechanics cadaver clinical article female fibula human joint mobility knee function knee surgery male posterolateral corner reconstruction range of motion rotation surgical anatomy tendon graft autotransplantation biomechanics joint characteristics and functions joint ligament knee Knee Injuries middle aged pathophysiology physiology tendon transplantation
Purpose To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees. Methods Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion. Reconstruction was performed using 2 independent tendon autografts. Afterward, the fibula and graft were loaded to failure. Results Reconstruction restored external rotation (0°: 11.75° ± 2.02° to 9.81° ± 1.81°, P =.57; 30°: 17.91° ± 1.32° to 13.96° ± 2.84°, P =.12; 60°: 15.86° ± 1.68° to 13.26° ± 3.58°, P =.41; 90°: 15.53° ± 1.62° to 14.07° ± 2.95°, P =.54) to the intact state, and posterior translation (0°: 3.66 ± 0.85 mm to 3.31 ± 0.89 mm, P =.87; 60°: 3.15 ± 0.45 mm to 2.96 ± 0.45 mm, P =.73; 90°: 2.74 ± 0.33 mm to 3.05 ± 0.41 mm, P =.41) and varus angulation (0°: 0.92° ± 0.35° to 1.98° ± 0.42°, P =.55; 30°: 2.65° ± 0.27° to 1.09° ± 0.90°, P =.37; 90°: 4.29° ± 0.44° to 2.53° ± 1.13°, P =.19) under most conditions. During load to failure testing, the construct revealed properties similar to those of native structures (yield load: 330.4 ± 45.8 N; ultimate load: 420.9 ± 37.4 N). Conclusions This technique restored external rotation to the intact state after PLC injury in all testing conditions, as well as posterior translation at 0°, 60°, and 90° of flexion, and varus angulation under all conditions tested except 60° of flexion. Clinical Relevance Clinically, this surgical technique may eliminate the need for a tibial tunnel for posterolateral corner reconstruction. © 2016
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https://doi.org/10.1016/j.arthro.2016.03.017View
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