Graft Length Changes and Optimal Knee Flexion Angles for Fixation in Posterolateral Corner Reconstruction: An In Vivo 3-Dimensional Simulation Analysis

Abstract

Background: Changes in graft length according to knee flexion and the ideal knee flexion angle at the time of graft fixation for posterolateral corner (PLC) reconstruction have yet to be clearly defined. Purposes: To investigate graft length changes according to knee flexion and determine the optimal graft fixation angle for knee flexion in PLC reconstruction. Study Design: Descriptive laboratory study. Methods: Ten healthy male volunteers underwent computed tomography at varying knee flexion angles (0°, 30°, 45°, 60°, and 90°). The Larson, LaPrade, Arciero, and Kim techniques were performed on 3-dimensional knee models reconstructed from the computed tomography scans. The lengths of each theoretically reconstructed graft were recorded and compared according to knee flexion angle changes. Results: In the Larson technique, the lengths of both arms of the sling were the longest at 30° of knee flexion but were not significantly different between 45° and 60° of knee flexion. In the LaPrade, Arciero, and Kim techniques, the length of the lateral collateral ligament arm at 30° of knee flexion was significantly longer than that at other knee flexion angles (P