Tibial-based Posterolateral Corner Reconstruction Following Proximal Fibula Resection Restores Knee Stability: A Case Report.

Journal of Orthopaedic Case Reports Pub Date : 2025-01-01 DOI:10.13107/jocr.2025.v15.i01.5154

Vitor Hugo Pinheiro, Pedro Marques, Kyle Borque, Rúben Fonseca, Fernando Fonseca, Andy Williams

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Abstract

Introduction: Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. This is the first report describing a wholly tibial-based PLC reconstruction.

Case report: A 50-year-old female presented with knee instability following proximal fibular resection for a benign tumor, associated with chronic anterior cruciate ligament (ACL) deficiency from a previous injury. Magnetic resonance imaging (MRI) showed fibular collateral ligament (FCL) and distal biceps femoris complete detachment. ACL reconstruction was combined with revision PLC reconstruction, placing the distal grafts, due to lack of fibula, both into the tibia. At 24-month follow-up, the patient reported excellent clinical outcomes.

Conclusion: In cases related to proximal fibula deficiency from resection or congenital causes, a wholly tibial-based PLC reconstruction can effectively restore stability.

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