Open exposure of the posterolateral corner of the knee is challenged by limitations of posterolateral ligamentous tissues
and posterior neurovascular structures. We have used a modification of a lateral femoral epicondyle osteotomy, described historically
for surgical management of posterolateral rotatory instability, as an approach to the posterolateral intraarticular structures.
The historic technique for ligamentous reconstruction has been abandoned because its nonanatomic fixation does not restore
ligamentous isometry. In this report, osteotomy of a bone block from the lateral femoral epicondyle is used to access the
joint space. The lateral collateral ligament is reflected distally and posteriorly through traction on the block. Once the
intraarticular disorder has been addressed, the lateral femoral epicondyle is secured in its native, anatomic position, thereby
restoring isometry and normal joint mechanics after surgery. This technique has been used successfully to address posterolateral
articular disorders on femoral and tibial sides. Postoperative magnetic resonance imaging verified restoration of lateral
collateral ligament anatomy. Physical examination at 0° and 30° knee flexion showed clinical stability at all postoperative
evaluations through 6 and 10 months followup. Using this technique, intraarticular disorders at the posterolateral corner
may be addressed in an open manner with anatomic reduction and preserved postoperative function of the lateral collateral
ligament.
Level of Evidence: Level V, expert opinion. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.