Arthroscopic reconstruction of the popliteus complex

PURPOSE: With combined PCL reconstruction and a minimal invasive (extra-anatomical) Larson's procedure, dorsal instability can be reduced by about 50-70 %. Better results are described by open and more anatomical procedures. In this study, a new, standardized, arthroscopic technique for anatomical popliteus tendon (PLT) reconstruction is evaluated.

METHODS: In 13 cadaver knees, an arthroscopic reconstruction of the PLT and the lateral collateral ligament was performed. Twelve defined landmarks were used for arthroscopic tunnel placement, and the distance of the tunnel locations to these specific landmarks was evaluated.

RESULTS: The femoral drill channel was located with a high degree of accuracy and reproducibility in the centre of the femoral footprint of the PLT (on average 1.1 (±1.6) mm distal from the centre). On the tibial side, the drill channel was in the distal third of the sulcus popliteus in all cases. On average, the channel was placed exactly at the level of the tip of the fibula (±1.5 mm) and 0.6 (±1.7) mm medially from the medial edge of the fibula. The centre of the channel was 13.4 (±2.3) mm distal from the joint line.

CONCLUSIONS: The presented arthroscopic technique for PLT reconstruction is standardized, reproducible and has a high accuracy for the placement of the tibial and femoral tunnel. The technique could be clinically relevant for future arthroscopic posterolateral corner reconstructions.

LEVEL OF EVIDENCE: III.