N°280 - January 2019
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Reconstruction of the posterolateral corner of the knee using the surgical technique performed at the SORI: feedback on an Australian approach
By Thomas Neri (1, 2, 3), Sebastien Lustig (4), Brett Fritsch (2), Myles Coolican (2), David Parker (2) in category TECHNIQUE
1. Centre hospitalier de Saint-Etienne, France / 2. Sydney Orthopaedic Research Institute (SORI), Sydney, Australia / 3. Laboratoire inter–universitaire de la biologie et de la motricité (LIBM EA 7424), Université de Lyon - Jean Monnet, France. / 4. Centre hospitalier de la croix rousse, Lyon, France
Lesions of the posterolateral corner (PLC) result in rotational instability and varus laxity. Most studies have shown that surgical reconstruction is usually necessary.2,7 The most widely used procedures include the Larson,1 LaPrade4 and ‘Versailles’ surgical techniques.6
In this technical note, we will describe in detail Larson’s method, as modified and developed by David Parker, Brett Fritsch and Myles Coolican at the Sydney Orthopaedic Research Institute (SORI).
Principles: anatomical and biomechanical considerations
The PLC is made up of three main stabilizer muscles, which are the lateral collateral ligament (LCL), the popliteal tendon (PT) and the fibulopopliteal ligament (FPL), and various secondary stabilizers: the posterolateral capsule, the biceps femoris tendon, the lateral tendon of the gastrocnemius, the iliotibial band, the fabellofibular ligament, the arcuate ligament complex and the proximal tibiofibular ligaments. Basically, the LCL provides tension against varus forces on the knee. The PT and the FPL form the popliteal complex. They control external rotation and, to a lesser extent, provide varus stability.
Larson’s reconstruction is achieved using two strands. The LCL is anatomically reconstructed using the first (anterior) strand, thus...
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