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. 2024 Aug 26;58(11):1585-1593.
doi: 10.1007/s43465-024-01243-y. eCollection 2024 Nov.

Posterior Cruciate Ligament and Posterolateral Corner Reconstruction: Clinical Outcomes Following Popliteal Tendon Tenodesis and Popliteal Tendon Reconstruction

Leonardo Adeo Ramos  1   2 , Edilson Andrade  1 , Gabriel Taniguti  1 , Renan Moukbel Chaim  1 , Alexandre Pedro Nicolini  1 , Jorge Yamashita  2 , Diego Costa Astur  1
Affiliations

Posterior Cruciate Ligament and Posterolateral Corner Reconstruction: Clinical Outcomes Following Popliteal Tendon Tenodesis and Popliteal Tendon Reconstruction

Leonardo Adeo Ramos et al. Indian J Orthop. .

Abstract

Introduction: Injuries to the posterolateral compartment (PLC) of the knee require special attention, as incorrect diagnosis and treatment may lead to considerable morbidity. However, no gold standard treatment has been established for PLC injuries.

Methods: 38 patients with concomitant (posterior cruciate ligament (PCL) and PLC injuries were divided into two groups according to surgical treatment of the proximal popliteal tendon injury. They were treated with anatomic popliteal tendon, lateral collateral ligament (LCL), and popliteofibular ligament (PFL) reconstruction (group 1; n = 19) and were treated with popliteal tendon tenodesis, LCL, and PFL reconstruction (group 2; n = 19). The Lysholm score, dial test, and lateral compartment opening on varus stress X-ray were used as outcome measurements evaluated before surgery and at 6, 12, and 24 months of follow-up.

Results: Overall, there was a progressive improvement in the Lysholm score and the lateral opening on varus stress radiography during the evaluated periods for both groups (p < 0.001). Patients from group 2 recorded better Lysholm scores than those from group 1 at 12- and 24-month follow-up (p = 0.02). Dial test was negative in all patients after 6, 12, and 24 months.

Conclusion: Patients with popliteal tendon tenodesis were found to have better Lysholm scores than patients with reconstruction after 12 and 24 months of follow-up. There was no difference in the lateral joint opening evaluated by stress radiography between groups. These results show that tenodesis could be a viable treatment option for lateral femoral condyle popliteal disruptions in the context of PLC and PCL combined injuries, and should be considered in the surgical planning process.

Keywords: Popliteal reconstruction; Popliteal tendon; Popliteal tenodesis; Posterior cruciate ligament; Posterolateral corner.

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Conflict of interest statement

Conflicts of interestAll authors declare no conflicts of interest or potential disclosures.

Figures

Fig. 1
Fig. 1
Diagnosis and treatment flowchart
Fig. 2
Fig. 2
A Shows the technique used in group 1: Following the anatomical points described by LaPrade. In B the LCL and PFL are reconstructed using Fanelli’s technique, with tenodesis of the popliteal tendon
Fig. 3
Fig. 3
Popliteal tendon tenodesis: anchor insertion at the PLT femoral insertion after Fanelli’s technique to reconstruct LCL and PFL
Fig. 4
Fig. 4
Front view radiographs improving varus stress from: a 34-year-old patient from group 1, female, before (A) and after (B) LaPrade reconstruction surgery; and a 23-year-old patient from group 2, female, before (C) and after reconstruction of LCL according to Fanelli’s technique, with tenodesis of the popliteal tendon (D)
See this image and copyright information in PMC

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