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Lateral Ligament Procedures

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Let's talk about lateral ligament, uh, procedures.

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I'm not gonna spend too much time of these,

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but these include poster lateral corner reconstruction

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and lateral extra articular tenodesis.

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Let's start first with poster lateral

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corner reconstructions.

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As I said in my first talk, these are in imperative

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in patients who have clinically significant poster

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lateral corner injuries.

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They can have var thrust gate

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and a positive dial test on exam.

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And the goal of poster lateral corner reconstruction is

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really to recreate that anatomy.

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So the main three restructures that they try

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to recreate is the fibular collateral ligament,

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the pope tendon,

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and then that smaller ligament,

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the pope teal fibular ligament,

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not the biceps femoral tendon,

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which I said is the third most important,

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but this is what they're trying to create anatomically.

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And this can be done via an open approach.

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And there have been described arthroscopic approaches.

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So we've seen this picture before, the popit tendon

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and muscle, the popliteal fibular ligament,

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and then in front of it the, um, p uh, the

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fibular collateral ligament.

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And so oftentimes they try to try to create this figure

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of a configuration

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that recreates the fibular collateral ligament,

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the pope tendon,

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and right at the tunnel, at the fibular syl,

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the pope teal fibular ligament.

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So here's an example of what one might look like,

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A poster later corner structure.

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This is the fibular collateral ligament limb of

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that reconstructed ligament.

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And this one looks, uh, relatively intact.

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Not a lot of literature on the

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postoperative appearance of these.

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Here's just an example

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of a poster lateral corner reconstruction that failed.

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You can see here this fiber discontinuity at the inferior

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aspect of the reconstructed ligament.

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And this patient had persistent var laxity.

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Um, I believe this was a police officer who wanted to try

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to get back to the field and do work, uh,

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but unfortunately wasn't interested in

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additional surgical procedures.

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So, uh, basically underwent, uh, rehab

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and bracing, uh, with his activities.

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Uh, this is a case. I don't know what to say.

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I mean, there's too much susceptible artifact,

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but on occasion when they use a lot of metal, uh,

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for their reconstructions, you will encounter these.

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And basically, uh, you can't really say much about the, uh,

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stability of that reconstructive ligament.

Report

Faculty

Donald Resnick, MD

Professor Emeritus, Department of Radiology

University of California, San Diego

Mini N. Pathria, MD, FRCP(C)

Division Chief, Musculoskeletal Imaging

University of California San Diego

Eric Y. Chang, MD

Adjunct Professor, Radiology

University of California, San Diego

Brady K. Huang, MD

Clinical Professor of Radiology

UC San Diego Medical Center

Tags

Musculoskeletal (MSK)

MRI

Knee