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Posterior problems in the knee

Posterior cruciate insufficiency and posterolateral rotatory insufficiency

Naval Regional Medical Center, Charleston, South Carolina

Douglas J. Blatz, M.D.

Naval Regional Medical Center, Charleston, South Carolina

John R. McCarroll, M.D.

Naval Regional Medical Center, Charleston, South Carolina

During a recent three-year period, 39 patients under went surgical procedures for lesions of the posterior complex of the knee. The results in 28 followed for greater than six months (average followup, 16 months) are reported; eight are presently in the early rehabili tative phase and three have been lost to followup.

In reconstruction for chronic laxity, a semitendino sus replacement of the posterior cruciate ligament with anterior advancement of the lateral arcuate com plex is recommended. Use of the medial gastroc nemius tendon is still advised in selected cases. Re construction for posterolateral rotatory laxity with an intact posterior cruciate is performed with anterior advancement of the popliteus tendon and the arcuate complex. Pes anserinus transfer, imbrication of the posterior oblique ligament, and biceps tenodesis may be performed as supplemental procedures.

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