This prospective cohort study compares primary repair versus anatomic allograft reconstruction of the posterolateral corner of the knee in 56 patients with minimum 2-year follow-up. The study tests whether acute repair — when performed with adequate tissue and early motion rehab — achieves equivalent stability to the modified 2-tailed reconstruction technique. The answer is clearly no.
For years, many surgeons repaired acute PLC tears when surgery was performed within 2-3 weeks and tissue looked adequate at the time of surgery — a reasonable assumption that this paper systematically disproves.
When you encounter a PLC injury after high-energy trauma, default to reconstruction using an anatomic allograft technique that restores all three deep-layer structures. Reserve repair only for true bony avulsions with enough bone fragment for screw fixation.
When you are planning an ACL or PCL reconstruction and the knee still has residual posterolateral laxity, the PLC must be addressed first — untreated PLC instability is a primary cause of cruciate graft failure.
The dial test remains your key clinical tool: external rotation asymmetry of 10 degrees or more (grade 2+) at 30 degrees of flexion indicates isolated PLC injury. Asymmetry at both 30 and 90 degrees implicates the PCL as well. Know this distinction cold for boards and for the OR.
This prospective cohort study compares primary repair versus anatomic allograft reconstruction of the posterolateral corner of the knee in 56 patients with minimum 2-year follow-up. The study tests whether acute repair — when performed with adequate tissue and early motion rehab — achieves equivalent stability to the modified 2-tailed reconstruction technique. The answer is clearly no.
For years, many surgeons repaired acute PLC tears when surgery was performed within 2-3 weeks and tissue looked adequate at the time of surgery — a reasonable assumption that this paper systematically disproves.
When you encounter a PLC injury after high-energy trauma, default to reconstruction using an anatomic allograft technique that restores all three deep-layer structures. Reserve repair only for true bony avulsions with enough bone fragment for screw fixation.
When you are planning an ACL or PCL reconstruction and the knee still has residual posterolateral laxity, the PLC must be addressed first — untreated PLC instability is a primary cause of cruciate graft failure.
The dial test remains your key clinical tool: external rotation asymmetry of 10 degrees or more (grade 2+) at 30 degrees of flexion indicates isolated PLC injury. Asymmetry at both 30 and 90 degrees implicates the PCL as well. Know this distinction cold for boards and for the OR.