LCL (lateral collateral ligament) and posterolateral corner reconstruction is an operation to restore stability to the outer side and back-outer corner of the knee after a significant ligament injury. These injuries often occur with other knee ligament damage.
An incision is made on the outer side of the knee. Tendon grafts (allograft or autograft) are used to reconstruct the damaged ligaments — typically the LCL, popliteus tendon, and popliteofibular ligament. The grafts are passed through bone tunnels and fixed with screws. The peroneal nerve is identified and protected. The operation takes two to three hours.
Reconstruction is recommended for symptomatic posterolateral instability causing the knee to give way, particularly into hyperextension and varus (bowing outward). It is usually performed as part of multi-ligament knee surgery (e.g., combined with ACL or PCL reconstruction).
Physiotherapy and bracing may be attempted for isolated partial injuries. Complete posterolateral corner injuries rarely heal adequately without surgery.
MRI and stress X-rays. Varus alignment should be corrected with osteotomy before or at the time of ligament reconstruction.
Restoration of posterolateral stability. Most patients achieve improved stability and function, though outcomes are more variable than isolated ACL reconstruction.
Loss of full flexion and extension is common.
From surgical dissection.
The common peroneal nerve wraps around the fibula and is at risk. Injury causes foot drop. Risk approximately 3-5%.
The reconstruction may stretch or fail.
Despite reconstruction.
Joint infection.
DVT.
General or spinal anaesthesia with nerve block.
Hinged brace locked in extension for six weeks. Crutches for six weeks. Progressive rehabilitation. Running at six months. Return to sport at nine to twelve months.
Reviews at two weeks, six weeks, three months, and six months.
The common peroneal nerve runs around the neck of the fibula on the outer knee, directly in the surgical field. It is carefully identified and protected during surgery.