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What Is Posterolateral Corner Reconstruction?

Posterolateral corner reconstruction is knee surgery used to rebuild major stabilizing structures on the outer and back portion of the knee. The main structures commonly reconstructed are the fibular collateral ligament, popliteus tendon, and popliteofibular ligament. These tissues resist varus opening and abnormal external rotation of the knee. Reconstruction uses tendon grafts to restore stability when the injured structures cannot be repaired reliably.

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What Is Posterolateral Corner Reconstruction?

Posterolateral corner reconstruction is knee surgery used to rebuild major stabilizing structures on the outer and back portion of the knee. The main structures commonly reconstructed are the fibular collateral ligament, popliteus tendon, and popliteofibular ligament. These tissues resist varus opening and abnormal external rotation of the knee. Reconstruction uses tendon grafts to restore stability when the injured structures cannot be repaired reliably.

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Why Is Posterolateral Corner Reconstruction Performed?

The procedure is used for high-grade posterolateral corner injuries that cause significant knee instability. These injuries commonly occur with tears of the anterior cruciate ligament, posterior cruciate ligament, or both after knee dislocation or major trauma. Chronic untreated posterolateral instability can overload cruciate-ligament grafts and contribute to poor knee function. Reconstruction is generally favored over simple repair for many complete injuries, particularly when tissue is chronically damaged or not suitable for direct repair.

How Is Posterolateral Corner Reconstruction Performed?

The surgeon identifies and protects the common peroneal nerve before creating bone tunnels or fixation sites in the femur, fibula, and sometimes tibia. Autograft or allograft tendon is passed through these sites to reproduce the orientation of the injured posterolateral stabilizers. The grafts are tensioned and fixed with the knee in carefully controlled positions to restore varus and rotational stability. Associated anterior cruciate ligament, posterior cruciate ligament, meniscus, or alignment procedures can be performed during the same operation or in planned stages.

What Is Recovery Like After Posterolateral Corner Reconstruction?

The reconstructed knee is protected with a brace and controlled weight-bearing during early graft healing. Rehabilitation emphasizes early but protected range of motion to reduce stiffness while avoiding excessive varus stress and external rotation. Strengthening and progressive weight-bearing are advanced according to graft healing and any other reconstructed ligaments. Return to pivoting sports commonly requires many months and depends on strength, stability, motion, and completion of rehabilitation milestones.

What Are the Risks and Complications?

Possible complications include infection, blood clots, stiffness, persistent instability, graft failure, and loss of knee motion. The common peroneal nerve is particularly important because it lies close to the operative field and can already be injured by the original knee trauma. Bone tunnels from simultaneous cruciate and posterolateral reconstructions can conflict if surgical planning is inadequate. Arthrofibrosis, residual varus or rotational laxity, and later posttraumatic arthritis can limit long-term function.

Frequently Asked Questions About Posterolateral Corner Reconstruction

What structures are rebuilt during posterolateral corner reconstruction?

Anatomic techniques commonly reconstruct the fibular collateral ligament, popliteus tendon, and popliteofibular ligament using tendon grafts.

Is posterolateral corner reconstruction often combined with ACL or PCL surgery?

Yes. Major posterolateral corner injuries frequently occur with anterior or posterior cruciate ligament tears and can require multiligament reconstruction.

Why is the common peroneal nerve important during PLC reconstruction?

The nerve passes close to the fibular head and surgical field. It must be identified and protected because injury can cause weakness in ankle or toe lifting and sensory loss.

Can a posterolateral corner injury be repaired instead of reconstructed?

Selected acute injuries can be repairable, but reconstruction is commonly favored for complete, chronic, or poor-quality tears because failure rates after repair can be higher.

References

Posterolateral Corner of the Knee: Current Concepts. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC4852053/. Date Accessed August 12, 2026.

Posterolateral corner knee injuries: a narrative review. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8419800/. Date Accessed August 12, 2026.

Anatomic Posterolateral Corner Reconstruction. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC5021087/. Date Accessed August 12, 2026.

Weightbearing Protocols After Posterolateral Corner Reconstruction: A Systematic Review. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC7975581/. Date Accessed August 12, 2026.

Incidence of Intraoperative and Postoperative Complications After Posterolateral Corner Reconstruction or Repair: A Systematic Review of the Current Literature. PubMed. https://pubmed.ncbi.nlm.nih.gov/33502894/. Date Accessed August 12, 2026.