Postero Lateral Corner Reconstruction
The Postero Lateral Corner (PLC) of the knee is a complex area of the knee. The diagnosis of acute and chronic Postero Lateral Corner knee injuries is also complex and requires various examination tests and imaging studies. Mr Sethi recommends to all patients with a complete, or Grade III injury, to undergo Postero Lateral Corner reconstruction. The timing of this surgery is crucial and ideally, acute injuries should be treated within the first three weeks with either a repair or an anatomic reconstruction of the injured structures.
Description of Posterolateral Reconstruction
Mr Sethi will assess the patient’s knee. Mr Sethi usually recommends a combined hybrid approach of repair for those repairable structures and a reconstruction of midsubstance tears of the Postero Lateral Corner for acute injuries; while in chronic injuries he generally performs a Postero Lateral Corner reconstruction.
Mr Sethi uses multiple surgical techniques to treat these injuries to include:
• Lateral Collateral Ligament (LCL) reconstructions
• Popliteus tendon reconstructions
• Proximal tibiofibular joint reconstructions
• Complete Postero Lateral Corner reconstructions
For chronic Postero Lateral Corner knee injuries, it may be necessary to perform a proximal tibial opening wedge osteotomy, first, and to have the osteotomy heal, then assess if they still have functional limitations after the osteotomy heals.
The postoperative rehabilitation for these injuries includes immediate range of motion within the “safe zone” decided by Mr Sethi at the time of surgery, to be nonweight bearing for six weeks postoperatively and to avoid isolated active hamstring exercises for the first four months postoperatively to avoid significant stress to the healing Postero Lateral corner repair and reconstruction procedures.