Clinical Comparisons of the Anatomical Reconstruction and Modified Biceps Rerouting Technique for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction

Background: The purpose of this study was to describe a one-stage operation for posterior cruciate ligament recon-struction with use of an Achilles tendon-bone allograft and a posterolateral corner reconstruction with use of two different methods, with a comparison of clinical outcomes in the two groups. Methods: Our study included forty-six patients who had undergone posterior cruciate ligament reconstruction with use of an Achilles tendon-bone allograft and posterolateral corner reconstruction with either anatomical reconstruction of the lateral collateral ligament and popliteus tendon with use of a tibialis posterior tendon allograft (twenty-one patients; Group A) or the modified biceps rerouting tenodesis (twenty-five patients; Group B) in an alternating fashion. Patients were assessed for knee instability with use of the dial test at 30 and 90, together with varus and posterior stress radiography. Results: At the two-year follow-up evaluation, although no significant difference was found on posterior stress radiog-raphy (mean and standard error, 5.7 ± 0.4 mm for Group A compared with 4.8 ± 0.4 mm for Group B), Group A showed more improvement than Group B on the dial test (16 ± 1 vs. 13 ± 1 at 30 and 17 ± 1 vs. 14 ± 1 at 90; p = 0.001 for both) and varus stress radiography (3.6 ± 0.3 mm vs. 2.6 ± 0.3 mm; p = 0.024), in the Lysholm (29.5 ± 2.4 vs. 22.3 ± 2.3; p = 0.037) and the International Knee Documentation Committee knee scores (p = 0.041), and less terminal flexion loss (4.0 ± 1.2 vs. 8.8 ± 1.3; p = 0.013)