Reconstruction of the Posterolateral Structure of the Knee

Graft attachment location is one of the important factors which affect the results of ligament reconstruction of the posterolateral structures of the knee. The reconstructive procedure is usually performed without the detailed information of ligamentous isometricity. In this cadaveric study, length changes between the possible graft attachment sites were calculated in a reconstructive procedure for the posterolateral structure of the knee. The three dimensional knee motion during active knee extension was recorded and the bony surface was digitized using CT images. The ligamentous isometry map for the lateral femoral condyle from the tibial attachment site was constructed. The length change pattern of the graft during knee motion was found to vary depending upon the femoral attachment site. The most isometric area was found to be located at a few millimeters anterior-distal to the lateral femoral epicondyle. The attachment sites of the supportive yet nonrestrictive graft were shown to be located at the lateral femoral epicondyle and head of the fibula.