Isometric reconstruction of knee posterolateral complex with the semitendinosus tendon / 中华骨科杂志

ABSTRACT

Objective To explore the isometric attachment site of the posterolateral structure in the femoral lateral condyle and introduce the method of knee posterolateral complex(PLC) reconstruction with the semitendinosus tendon. Methods Isometric reconstruction of the chronic PLC injury of knee joint in 18 cases, were performed with the semitendinosus tendon from February 2001 to February 2005. Of all patients, there were 12 males and 6 females, average age was 39 years old(range, 19-52 years old). All cases were chronic injuries, with duration of 1.5-14 months. 3 cases were simple PLC injury, 10 cases were PLC injury with posterior cruciate ligament(PCL) injury, 2 of which had undergone PCL reconstruction about 6.5 months. 3 cases combined with anterior cruciate ligament(ACL) injury, 2 cases combined with ACL and PCL injury. To put in the double semitendinosus tendon from the bony tunnel of anatomical insertion of the fibular collateral ligment in caput fibulae and put out from the bony tunnel of anatomical insertion of the popliterofibular ligment in the caput fibulae, then fix them respectively in the isometic bony tunnel of the femoral lateral condyle. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results It was relatively isometric from the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliterofibular ligment in the caput fibulae. The better isometric attachment site was from the anatomical caput fibulae attachment site to 8-10 mm in front of the anatomical femoral attachment site of the lateral collateral ligament. The average follow-up period was 14 months(12-24 months). There was no varus knee instability in full extension. At 30? flexion, one-grade varus instability was found in 2. At 30? and 90? flexion, external rotation range increased by 6? in 3 cases, remained the same in 14 cases, and decreased in 1 case, all compared with the healthy side. Conclusion The method provided good stability for the knee and acquired satisfactory clinical results.