Posterior Cruciate Ligament and Posterolateral Corner Reconstruction: Clinical Outcomes Following Popliteal Tendon Tenodesis and Popliteal Tendon Reconstruction

Leonardo Adeo Ramos; Edilson Andrade; Gabriel Taniguti; Renan Moukbel Chaim; Alexandre Pedro Nicolini; Jorge Yamashita; Diego Costa Astur

doi:10.1007/s43465-024-01243-y

Posterior Cruciate Ligament and Posterolateral Corner Reconstruction: Clinical Outcomes Following Popliteal Tendon Tenodesis and Popliteal Tendon Reconstruction

Indian J Orthop. 2024 Aug 26;58(11):1585-1593. doi: 10.1007/s43465-024-01243-y. eCollection 2024 Nov.

Authors

Leonardo Adeo Ramos^{1

2}, Edilson Andrade¹, Gabriel Taniguti¹, Renan Moukbel Chaim¹, Alexandre Pedro Nicolini¹, Jorge Yamashita², Diego Costa Astur¹

Affiliations

¹ Orthopaedic and Traumatology Department, Centro de Traumatologia do Esporte, Universidade Federal de São Paulo- Escola Paulista de Medicina, Rua Borges Lagoa 783, São Paulo, SP Brazil.
² Hospital Nipo-Brasileiro de São Paulo, São Paulo, Brazil.

PMID: 39539325
PMCID: PMC11555166 (available on 2025-08-26)
DOI: 10.1007/s43465-024-01243-y

Abstract

Introduction: Injuries to the posterolateral compartment (PLC) of the knee require special attention, as incorrect diagnosis and treatment may lead to considerable morbidity. However, no gold standard treatment has been established for PLC injuries.

Methods: 38 patients with concomitant (posterior cruciate ligament (PCL) and PLC injuries were divided into two groups according to surgical treatment of the proximal popliteal tendon injury. They were treated with anatomic popliteal tendon, lateral collateral ligament (LCL), and popliteofibular ligament (PFL) reconstruction (group 1; n = 19) and were treated with popliteal tendon tenodesis, LCL, and PFL reconstruction (group 2; n = 19). The Lysholm score, dial test, and lateral compartment opening on varus stress X-ray were used as outcome measurements evaluated before surgery and at 6, 12, and 24 months of follow-up.

Results: Overall, there was a progressive improvement in the Lysholm score and the lateral opening on varus stress radiography during the evaluated periods for both groups (p < 0.001). Patients from group 2 recorded better Lysholm scores than those from group 1 at 12- and 24-month follow-up (p = 0.02). Dial test was negative in all patients after 6, 12, and 24 months.

Conclusion: Patients with popliteal tendon tenodesis were found to have better Lysholm scores than patients with reconstruction after 12 and 24 months of follow-up. There was no difference in the lateral joint opening evaluated by stress radiography between groups. These results show that tenodesis could be a viable treatment option for lateral femoral condyle popliteal disruptions in the context of PLC and PCL combined injuries, and should be considered in the surgical planning process.

Keywords: Popliteal reconstruction; Popliteal tendon; Popliteal tenodesis; Posterior cruciate ligament; Posterolateral corner.

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