Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction
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ARTHROSCOPY AND SPORTS MEDICINE
Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction Sebastian Weiss1 · Matthias Krause1 · Karl‑Heinz Frosch1 Received: 4 April 2020 / Accepted: 9 September 2020 © The Author(s) 2020
Abstract Introduction Injuries of the posterolateral corner (PLC) of the knee lead to chronic lateral and external rotational instability and are often associated with PCL injuries. Numerous surgical techniques for repair and reconstruction of the PLC are established. Recently, several arthroscopic techniques have been published in order to address different degrees of PLC injuries through reconstruction of one or more functional structures. The purpose of this systematic review is to give an overview about arthroscopic techniques of posterolateral corner reconstructions and to evaluate their safeness. Materials and methods A systematic review of the literature on arthroscopic reconstructions of the posterolateral corner of the knee according to the PRISMA guidelines was performed using PubMed MEDLINE and Web of Science Databases on June 15th, 2020. Inclusion criteria were descriptions of surgical techniques to reconstruct different aspects of the posterolateral corner either strictly arthroscopically or minimally-invasive with an arthroscopic assistance. Results Arthroscopic techniques differ with regard to the extent of reconstructed units (popliteus tendon, popliteofibular ligament, lateral collateral ligament), surgical approach (transseptal, lateral) and biomechanical results (anatomic vs. nonanatomic reconstruction, restoration of rotational instability and/or lateral instability). Conclusion Different approaches to arthroscopic PLC reconstruction are presented, yet clinical results are scarce. Up to now good and excellent clinical results are reported. No major complications are reported in the literature so far. Keywords Knee · Posterolateral corner · Popliteus · Lateral collateral ligament · Reconstruction · Arthroscopy
Introduction Anatomy of the posterolateral corner The posterolateral corner of the knee has a complex anatomic composition, which was only thoroughly discovered in recent years and has since gained increased focus in diagnostics and treatment. It consists of the lateral collateral ligament (LCL) and the popliteus complex (PTC). The popliteus complex itself contains the popliteus muscle tendon unit (PLT) and the arcuate complex (AC), which is formed by the popliteofibular ligament (PFL), the fabellofibular ligament and the popliteomeniscal fibers [1].
In its complexity, the posterolateral corner is essential to stabilization against various forces to the knee. The arcuate complex with its most prominent part, the popliteofibular ligament, serves primarily as a static stabilizer against external tibial rotation [2]. Together with the popliteus muscle tendon unit, which also functions as a dynamic stabilizer against external rotation, the arcuate complex prevents posterior tibial translation [1, 3, 4]. In PCL
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