Back to Search
Start Over
Can Anatomic Posterolateral Corner Reconstruction Using a Fibular Tunnel Restore Fibular Footprints of the Posterolateral Complex? A Cadaveric Study
- Source :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery. 36:1355-1362
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Purpose This study aimed to (1) quantitatively analyze the fibular footprints of the lateral collateral ligament (LCL) and popliteofibular ligament (PFL) and (2) evaluate whether a fibular tunnel can restore the LCL and PFL fibular footprints simultaneously without modification in anatomic posterolateral corner reconstruction of the knee. Methods In 20 cadaveric knees, anatomic characteristics, such as diameter, location and relationship with anatomic landmarks, of the LCL and PFL footprints were analyzed. Subsequently, a fibular tunnel that connected the LCL and PFL footprint centers was created with 1.5 mm drill bit, and tunnel depth, which is defined as the distance between the tunnel and the nearest cortex, was evaluated. An additional tunnel from the anteroinferior border of the LCL footprint to the posteroinferior border of the PFL footprint was created, and its tunnel depth was evaluated as well and compared with that of the original tunnel. Results The LCL footprint was longitudinally ovoid (8.4 ± 1.0 × 13 ± 1.0 mm), and its inferior margin corresponded well with the lateral apex of the fibula (distance, 1.0 ± 0.7 mm). The PFL footprint was round (9.7 ± 1.3 × 9.0 ± 1.1 mm), and its center was very close to the tip of the fibular styloid process (1.2 ± 0.8 mm). The tunnel depth of the original fibular tunnel was 1.8 ± 0.7 mm, and it was very shallow for tunnel reaming. On the contrary, the tunnel depth of the modified fibular tunnel (6.4 ± 1.1 mm) was significantly higher than that of the original tunnel (P Conclusions A single fibular tunnel cannot reproduce the LCL and PFL footprint centers simultaneously because the trajectory is too close to the cortex. A modified fibular tunnel, using the margins of the footprints, is recommended to avoid cortical blowout. Clinical Relevance A modified fibular tunnel that covers only portions of the LCL and PFL footprints, from the anteroinferior LCL footprint to the posteroinferior PFL footprint, is less likely to blow out the lateral fibula than is a similar tunnel using the anatomic footprint centers.
- Subjects :
- Male
Knee Joint
Knee Injuries
Footprint
03 medical and health sciences
0302 clinical medicine
Popliteofibular ligament
Cadaver
Posterolateral corner
medicine
Humans
Orthopedic Procedures
Orthopedics and Sports Medicine
Fibula
Aged
030222 orthopedics
business.industry
030229 sport sciences
Anatomy
Plastic Surgery Procedures
Blow out
medicine.anatomical_structure
Ligaments, Articular
Ligament
Female
Anatomic Landmarks
Cadaveric spasm
business
Subjects
Details
- ISSN :
- 07498063
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Arthroscopy: The Journal of Arthroscopic & Related Surgery
- Accession number :
- edsair.doi.dedup.....f075c7651f98e8f8a44ad7c80319dd24