Surgical management of posterolateral corner injuries of the knee

Posterolateral corner ligament injuries are somewhat uncommon but occur with sufficient frequency that clinical outcomes are compromised when the injury is missed. The diagnosis and treatment of these injuries can be challenging. A complete physical examination is the most important diagnostic modality, with imaging used to confirm clinical suspicions. Recent studies have supported reconstruction or augmentation in acute injuries, especially with mid-substance tears. Osteotomy should be performed as first-line treatment when varus alignment or a varus-thrust gait pattern is identified. A double femoral tunnel, fibular-based posterolateral corner reconstruction can be effective in restoring varus and rotation stability in chronic cases.