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Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim, Hee-Don Han, In-Sung Lee, Sung-Guk Kim, and Yong-Min Chun JBJS Essent Surg Tech Volume 2(2):e8 April 11, 2012 ©2012 by The Journal of Bone and Joint Surgery, Inc.

Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

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Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8 ©2012 by The Journal of Bone and Joint Surgery, Inc.

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Page 1: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament

Reconstruction

by Sung-Jae Kim, Sung-Hwan Kim, Hee-Don Han, In-Sung Lee, Sung-Guk Kim, and Yong-Min Chun

JBJS Essent Surg TechVolume 2(2):e8April 11, 2012

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Creating the femoral socket for posterolateral corner reconstruction in the medial femoral condyle.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 13: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

The Achilles tendon-bone allograft for the reconstruction of the PCL. The bone plug was trimmed for tibial fixation.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 14: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Skin incision for posterolateral corner reconstruction, starting from the anterior aspect of the fibular head and extending to the femoral epicondyle.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 15: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Creating the tibial tunnel for posterolateral corner reconstruction.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 16: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Creating the fibular tunnel for posterolateral corner reconstruction.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 17: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Each end of the graft passed out of the tibial and fibular tunnels.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 18: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Isometricity test.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 19: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Femoral fixation for reconstructing the popliteus tendon (arrow).

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 20: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

Femoral fixation for reconstructing the LCL (black arrow) over the popliteus tendon (white arrow).

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 21: Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,

The tensioner for the graft in tibial fixation.

Sung-Jae Kim et al. JBJS Essent Surg Tech 2012;2:e8

©2012 by The Journal of Bone and Joint Surgery, Inc.