Editorial Commentary: Shedding Light on the Posterolateral Corner of the Knee: Can We Do it With the Scope? Is There a Real Benefit?

Jorge Chahla, Brady T Williams, Robert F LaPrade
Arthroscopy 2020, 36 (4): 1132-1134
Historically described as the "dark side of the knee," the posterolateral corner of the knee has been a significant focus of anatomic, biomechanical, and clinical outcomes research due to poor treatment outcomes for these injuries before improvements over the past 2 decades. These research efforts have resulted in significant improvements in the understanding, diagnosis, and surgical treatment of these injuries. Perhaps most importantly, improved understanding of the anatomy and biomechanics has led to the development of anatomic-based reconstructions, which have been subsequently validated with both biomechanical and clinical outcomes. Due to the complex anatomy and proximity of neurovascular structures, reconstructions have historically used large "hockey stick" incisions to provide adequate visualization to identify the anatomic insertions of the static stabilizers and ensure adequate protection of neurovascular structures. These anatomic-based techniques have significantly improved the clinical and objective outcomes of the surgical treatment of posterolateral knee injuries. However, as techniques have evolved and the clinical outcomes have improved, clinicians have attempted to develop and employ less-invasive and arthroscopically assisted techniques. Specifically, given the steep learning curve, paucity of clinical outcomes, increased operative time, and the limited view of the anatomy, which may increase the risk of nonanatomic tunnel placement, and injuries to surrounding structures, we cannot support an arthroscopic approach at this time.

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