This cadaveric biomechanical study by LaPrade (2004) describes and validates the first anatomical 2-graft technique to reconstruct all 3 primary static stabilizers of the posterolateral knee. The study tests whether this reconstruction restores varus and external rotation stability in knees with simulated grade III posterolateral corner injuries.
Untreated grade III posterolateral corner injuries are a leading cause of ACL and PCL reconstruction graft failure. Prior surgical options (biceps tenodesis, IT band grafts, femoral bone block advancements) did not restore normal anatomy and carried risks of overconstrant or donor-site morbidity.
When you encounter a chronic grade III posterolateral corner injury — especially combined with ACL or PCL injury — the LaPrade technique gives you an anatomical framework: two separate femoral tunnels for the FCL and popliteus tendon, a shared fibular tunnel for FCL and popliteofibular ligament reconstruction, and a shared tibial exit point.
Fix the FCL graft at 30° flexion with neutral rotation and valgus stress. Fix both tibial grafts simultaneously at 60° flexion and 5° internal rotation. Keep the patient non-weightbearing for 6 weeks, but do not restrict range of motion.
The dial test (at 30° and 90°), reverse pivot shift, and varus thrust gait are your key physical exam tools. If the dial test is positive at 90° but not 30°, suspect a combined PCL plus posterolateral corner injury rather than an isolated posterolateral injury.
This cadaveric biomechanical study by LaPrade (2004) describes and validates the first anatomical 2-graft technique to reconstruct all 3 primary static stabilizers of the posterolateral knee. The study tests whether this reconstruction restores varus and external rotation stability in knees with simulated grade III posterolateral corner injuries.
Untreated grade III posterolateral corner injuries are a leading cause of ACL and PCL reconstruction graft failure. Prior surgical options (biceps tenodesis, IT band grafts, femoral bone block advancements) did not restore normal anatomy and carried risks of overconstrant or donor-site morbidity.
When you encounter a chronic grade III posterolateral corner injury — especially combined with ACL or PCL injury — the LaPrade technique gives you an anatomical framework: two separate femoral tunnels for the FCL and popliteus tendon, a shared fibular tunnel for FCL and popliteofibular ligament reconstruction, and a shared tibial exit point.
Fix the FCL graft at 30° flexion with neutral rotation and valgus stress. Fix both tibial grafts simultaneously at 60° flexion and 5° internal rotation. Keep the patient non-weightbearing for 6 weeks, but do not restrict range of motion.
The dial test (at 30° and 90°), reverse pivot shift, and varus thrust gait are your key physical exam tools. If the dial test is positive at 90° but not 30°, suspect a combined PCL plus posterolateral corner injury rather than an isolated posterolateral injury.