Finding the Optimal Balance – Isolated Posterolateral Corner Reconstruction with Allograft Tendon in a Combined Posterolateral Corner-Posterior Cruciate Ligament Injury: A Case Report

Introduction: Posterolateral corner (PLC) injuries are often associated with cruciate ligament tears. Historically known as the “dark side” of the knee, advancements have greatly improved our understanding of the PLC, offering various management options today. Case Report: We present the case of a 44-year-old male with a combined PLC and posterior cruciate ligament (PCL) Grade 2 injury. He was managed with an isolated PLC reconstruction using an open anatomical Arciero-based technique with a tibialis anterior allograft. At subsequent follow-ups, the patient was shown to have excellent knee functional outcomes, no instability, and ease of performing regular activities, including low to moderate-demand sporting activities. Conclusion: Effective management of combined PLC and PCL injuries necessitates early identification of the PLC injury and a case-specific management approach, considering factors such as the patient’s condition, surgeon expertise, and graft availability. Allografts are a viable alternative to autografts for PLC reconstruction, offering several advantages over the latter. Keywords: Posterolateral corner, posterior cruciate ligament, allografts, isolated posterolateral corner reconstruction, arciero technique, three window technique, multiligament knee injuries.