Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerations and functional results Camilo Partezani Helito a,b , Marcel Faraco Sobrado a, ⁎, Pedro Nogueira Giglio a , Marcelo Batista Bonadio a , Marco Kawamura Demange a , José Ricardo Pécora a , Gilberto Luis Camanho a , Fabio Janson Angelini a a Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil b Hospital Sírio Libanês, São Paulo, Brazil article info abstract Article history: Received 3 September 2018 Received in revised form 10 October 2018 Accepted 5 December 2018 Available online xxxx Background: To report the functional outcomes and complications from reconstructing the knee posterolateral complex (PLC), associated with one-stage opening-wedge tibial valgus osteotomy, and discuss the technical feasibility of this procedure. Methods: Five patients with chronic PLC injuries and varus deviation of the mechanical axis, as- sociated with central pivot injuries or not, underwent medial opening-wedge high tibial osteotomy combined with PLC reconstruction. The lateral collateral ligament, popliteal tendon, and popliteofibular ligament were reconstructed using a single femoral tunnel. Patients were assessed on physical examination, range-of-motion and functional scales, and radiographs. The International Knee Documentation Committee (IKDC) score, Lysholm score, and Knee In- jury and Osteoarthritis Outcome score (KOOS) were determined. Results: Five patients were evaluated: four presented with central pivot injury, and one had an isolated PLC injury. The mean time between injury and surgery was 40 ± 6.5 months (± is in- dicating standard deviation value). Four patients had minimal residual instability on physical examination, with a lateral opening at varus stress of ±3+ at 30° flexion. The means of the IKDC score, Lysholm score, and KOOS were 67.8 ± 9.2, 83.0 ± 9.3, and 79.2 ± 5.9, respectively. All patients showed satisfactory consolidation of osteotomy in 2.6 ± 0.9 months. Conclusions: The results of this series indicate that one-stage PLC ligament reconstruction asso- ciated with medial opening-wedge valgus osteotomy is feasible and shows satisfactory func- tional results with a low rate of complications. A one-stage procedure might be indicated for young patients with high functionality and more pronounced posterolateral instabilities. © 2018 Elsevier B.V. All rights reserved. Keywords: Knee dislocation Multiligament injury Posterolateral complex Posterolateral corner reconstruction Single femoral tunnel Tibial valgus osteotomy 1. Introduction Posterolateral complex (PLC) injuries comprise approximately 16% of all knee ligament injuries, and most of these injuries af- fect the central pivot ligaments. Isolated injuries occur in two percent of all cases [1]. For grade I injuries or injuries without in- stability, conservative treatment progresses with satisfactory results [2]. However, more extensive injuries should be treated surgically. Regarding grade III injuries, persistent instability and degenerative changes can occur in cases of non-surgical treat- The Knee xxx (xxxx) xxx ⁎ Corresponding author at: Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, São Paulo CEP: 05403-010, Brazil. E-mail address: marcel.sobrado@usp.br. (M.F. Sobrado). THEKNE-02750; No of Pages 8 https://doi.org/10.1016/j.knee.2018.12.001 0968-0160/© 2018 Elsevier B.V. All rights reserved. Contents lists available at ScienceDirect The Knee Please cite this article as: C.P. Helito, M.F. Sobrado, P.N. Giglio, et al., Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerati..., The Knee, https://doi.org/10.1016/j.knee.2018.12.001