Arthroscopic-Assisted Tibiofibular-Based Posterolateral Corner Knee Reconstruction.

Abstract

Posterolateral corner knee reconstructions can be divided into fibular-based and tibiofibular-based reconstructions. Tibiofibular-based posterolateral corner knee reconstructions have been shown to produce good clinical outcomes. Tibiofibular-based reconstructions allow the reconstruction of the 3 main components of the posterolateral corner: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. The "Versailles" technique is a tibiofibular-based reconstruction with a curved femoral tunnel. The curved femoral tunnel could potentially decrease the risk of tunnel collision with other femoral tunnels. Our modification of this Versailles technique uses an arthroscopic approach for drilling of the tibial tunnel, allowing for a minimally invasive approach. Our modified technique uses 2 posterolateral portals for drilling of the tibial tunnel and graft passage to the direct lateral portal. Extensive dissection of the posterior part of the tibia is avoided by this arthroscopic approach. Conversion to a dual mini-open approach is then performed for femoral and fibular tunnel drilling and graft passage.