AANA/SOMOS Course Materials (August 2021)-Posterolateral Reconstruction Demo

Video Transcription

Video Summary

The video transcript details a surgical procedure focusing on the reconstruction of the posterolateral corner (PLC) of the knee, using mainly the Arciero and LaPrade techniques. Key anatomical landmarks such as the fibular head, lateral collateral ligament (LCL), tibial tubercle, Gerdy's tubercle, and the lateral epicondyle are identified for precise incision placement. The dissection begins with neurolysis of the common peroneal nerve to safely expose it and create working windows. <br /><br />Fibular and tibial tunnels are carefully drilled using specific guides—5.5 mm for the fibula and 8 mm for the tibia—to accommodate grafts. Grafts, typically split Achilles tendon allografts with bone blocks, are prepared and reinforced at the tendon-bone junction to prevent friability. The popliteus and LCL graft limbs are passed through created windows and tunnels in anatomic paths, with careful attention to soft tissue clearance to avoid impingement.<br /><br />Fixation involves interference screws and tensioning the grafts at specific knee flexion angles with valgus load. The procedure emphasizes avoiding tunnel convergence, especially when combined with ACL reconstruction, and discusses suture approaches to reinforce external rotation stability. The video concludes with graft tensioning, fixation, and repair of incisions, providing a comprehensive guide to PLC reconstruction techniques.

Keywords

posterolateral corner reconstruction

Arciero technique

LaPrade technique

common peroneal nerve neurolysis

fibular and tibial tunnel drilling

Achilles tendon allograft

lateral collateral ligament fixation