PLC and Popliteus Tendon Reconstruction
摘要
Anatomically, the posterolateral corner (PLC) comprises several key structures, including the lateral collateral ligament (LCL) and the popliteus complex, which consists of the popliteus tendon and the arcuate complex. These components work together to stabilize the knee against varus and posterolateral forces and contribute to dynamic stabilization through the contraction of the popliteus muscle. Injury mechanisms often involve direct varus stress, hyperextension, or rotational forces and can be classified based on the extent of damage to the lateral structures. Classification systems categorize PLC injuries by assessing the extent of damage to the lateral structures or the severity of posterolateral rotatory instability. While there is no standardized algorithm for the treatment of PLC injuries, the management of PLC injuries is variable, with surgical treatment recommended for Grade II and III injuries. Current trends favor reconstruction over repair due to superior outcomes in complex cases. Various surgical techniques have been developed, including the Larson, Arciero, LaPrade, and popliteus bypass techniques. Each method has its own advantages and indications based on the specific injury type and associated conditions. In recent years, innovative arthroscopic reconstruction techniques have been introduced, provided the surgeon has advanced arthroscopic skills.