{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:32:46Z","timestamp":1777710766733,"version":"3.51.4"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Precise fibular tunnel placement in posterolateral corner (PLC) reconstruction is crucial in restoring rotational and lateral stability. Despite the recent progress of arthroscopic PLC reconstruction techniques, landmarks for arthroscopic fibular tunnel placement and a comparison to open tunnel placement have not yet been described. This study aimed to (1) identify reasonable soft-tissue and bony landmarks, which can be identified by either arthroscopy, fluoroscopy, or open surgery in anatomic fibular tunnel placement and (2) to compare accuracy and reliability of arthroscopic fibular tunnel placement with open surgery.<\/jats:p><jats:p>\n          Materials and Methods\u2003In a retrospective study, 41 magnetic resonance images (MRIs) of the knee were analyzed with emphasis on distances of an ideal anatomic fibular tunnel to 11 soft-tissue and bony landmarks. Subsequently, in eight cadaver knees, the ideal fibular tunnel was created arthroscopically and with a standard open technique from antero-latero-inferior to postero-medio-superior with a 2-mm K-wire. Positions of both tunnels were compared on postinterventional computed tomography scans.<\/jats:p><jats:p>\n          Results\u2003Based on MRI measurements, the anatomic tunnel entry should be 14.50 (\u00b12.18) mm distal to the tip of the fibular styloid and 10.76 (\u00b11.37) mm posterior to the anterior edge of the fibula. The anatomic fibular tunnel exit was located 12.89 (\u00b12.35) mm below the tip of the fibular head. Arthroscopic fibular tunnel placement was reliable in all cases. Instead, in five out of the eight cases with open surgery, the fibular tunnel crossed the defined safety distance to the closest cortical edge\/tibiofibular joint (distance\u2009&lt;\u20098\u2009mm).<\/jats:p><jats:p>\n          Conclusions\u2003Reliable soft-tissue and bony landmarks of the fibular head allow arthroscopic anatomic fibular tunnel placement in PLC surgery, which shows a lower risk of tunnel malposition compared with open surgical techniques. Future studies will have to show whether clinical results of arthroscopic PLC reconstruction are in line with this study's technical results.<\/jats:p><jats:p>\n          Level of Evidence\u2003Level III.<\/jats:p>","DOI":"10.1055\/s-0042-1748897","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T23:55:52Z","timestamp":1657238152000},"page":"977-987","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of Arthroscopic versus Open Placement of the Fibular Tunnel in Posterolateral Corner Reconstruction"],"prefix":"10.1055","volume":"36","author":[{"given":"Matthias","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0668-981X","authenticated-orcid":false,"given":"Sebastian","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Philipp","family":"Kolb","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Schwartzkopf","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannik","family":"Frings","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"P\u00fcschel","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etienne","family":"Cavaignac","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Trauma, Clinique Universitaire du Sport, H\u00f4pital Pierre Paul Riquet, Toulouse, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Sonnery-Cottet","sequence":"additional","affiliation":[{"name":"Centre Orthop\u00e9dique Santy; FIFA Medical Center of Excellence; H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay-G\u00e9n\u00e9rale de Sant\u00e9, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl-Heinz","family":"Frosch","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1016\/j.arthro.2017.03.035","article-title":"Kinematics of different components of the posterolateral corner of the knee in the lateral collateral ligament-intact state: a human cadaveric study","volume":"33","author":"C Domnick","year":"2017","journal-title":"Arthroscopy"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1007\/s00167-013-2643-4","article-title":"The arcuate ligament revisited: role of the posterolateral structures in providing static stability in the knee joint","volume":"22","author":"M Thaunat","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1177\/0363546509349493","article-title":"Analysis of the static function of the popliteus tendon and evaluation of an anatomic reconstruction: the \u201cfifth ligament\u201d of the knee","volume":"38","author":"R F LaPrade","year":"2010","journal-title":"Am J Sports Med"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1177\/0363546506287743","article-title":"An analysis of the causes of failure in 57 consecutive posterolateral operative procedures","volume":"34","author":"F R Noyes","year":"2006","journal-title":"Am J Sports Med"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.arthro.2005.12.003","article-title":"Anatomic reconstructive surgery for posterolateral instability of the knee","volume":"22","author":"K H Yoon","year":"2006","journal-title":"Arthroscopy"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"3114","DOI":"10.1007\/s00167-014-3000-y","article-title":"Arthroscopic reconstruction of the popliteus complex: accuracy and reproducibility of a new surgical technique","volume":"23","author":"K H Frosch","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00064-015-0432-6","article-title":"Arthroscopic popliteus bypass graft for posterolateral instabilities of the knee : a new surgical technique","volume":"28","author":"K H Frosch","year":"2016","journal-title":"Oper Orthop Traumatol"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1055\/s-0038-1666832","article-title":"Posterolateral rotatory knee instability-MRI evaluation of anatomic landmarks for tibial drill tunnel placement in open and arthroscopic popliteus tendon reconstruction","volume":"32","author":"M Krause","year":"2019","journal-title":"J Knee Surg"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00167-008-0696-6","article-title":"A comparison of modified Larson and \u2018anatomic\u2019 posterolateral corner reconstructions in knees with combined PCL and posterolateral corner deficiency","volume":"17","author":"S Apsingi","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s00167-014-3085-3","article-title":"Part I: an anatomic-based tunnel in the fibular head for posterolateral corner reconstruction using magnetic resonance imaging","volume":"23","author":"K C Bohm","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1177\/03635465010290041501","article-title":"Anatomic and biomechanical study of the lateral collateral and popliteofibular ligaments","volume":"29","author":"T Sugita","year":"2001","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1177\/0363546503262687","article-title":"An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique","volume":"32","author":"R F LaPrade","year":"2004","journal-title":"Am J Sports Med"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s00167-003-0379-2","article-title":"A biomechanical analysis of two reconstructive approaches to the posterolateral corner of the knee","volume":"11","author":"A Kanamori","year":"2003","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"09","key":"ref14","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.arthro.2005.06.008","article-title":"Anatomic posterolateral corner knee reconstruction","volume":"21","author":"R A Arciero","year":"2005","journal-title":"Arthroscopy"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1177\/0363546513488866","article-title":"Posterolateral corner reconstruction using the single fibular sling method for posterolateral rotatory instability of the knee","volume":"41","author":"B S Yang","year":"2013","journal-title":"Am J Sports Med"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1007\/s00167-016-4304-x","article-title":"Morphology of the fibular insertion of the posterolateral corner and biceps femoris tendon","volume":"25","author":"H Takahashi","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1177\/03635465030310062101","article-title":"The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon","volume":"31","author":"R F LaPrade","year":"2003","journal-title":"Am J Sports Med"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.arthro.2019.11.099","article-title":"Can anatomic posterolateral corner reconstruction using a fibular tunnel restore fibular footprints of the posterolateral complex? A cadaveric study","volume":"36","author":"Y S Lee","year":"2020","journal-title":"Arthroscopy"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1007\/s00167-015-3531-x","article-title":"Anatomical popliteofibular ligament reconstruction of the knee joints: an all-arthroscopic technique","volume":"23","author":"G Y Song","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref20","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1007\/s00402-020-03607-z","article-title":"Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction","volume":"140","author":"S Weiss","year":"2020","journal-title":"Arch Orthop Trauma Surg"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.1016\/j.eats.2018.10.010","article-title":"Anatomic reconstruction of the posterolateral corner: an all-arthroscopic technique","volume":"8","author":"J Frings","year":"2019","journal-title":"Arthrosc Tech"},{"issue":"09","key":"ref22","doi-asserted-by":"crossref","first-page":"e999","DOI":"10.1016\/j.eats.2019.05.010","article-title":"An all-arthroscopic technique for complex posterolateral corner reconstruction","volume":"8","author":"J P Kolb","year":"2019","journal-title":"Arthrosc Tech"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.arthro.2019.10.035","article-title":"Anatomic, all-arthroscopic reconstruction of posterolateral corner of the knee: a cadaveric biomechanical study","volume":"36","author":"P Liu","year":"2020","journal-title":"Arthroscopy"},{"issue":"08","key":"ref24","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1016\/j.arthro.2019.03.019","article-title":"The clinical outcome of arthroscopic versus open popliteal tendon reconstruction combined with posterior cruciate ligament reconstruction in patients with type a posterolateral rotational instability","volume":"35","author":"Y Li","year":"2019","journal-title":"Arthroscopy"},{"issue":"12","key":"ref25","doi-asserted-by":"crossref","first-page":"e1977","DOI":"10.1016\/j.eats.2020.08.026","article-title":"Arthroscopic identification of the knee posterolateral corner structures and anatomic arthroscopic posterolateral corner reconstruction: technical note\u2014part 1","volume":"9","author":"B Freychet","year":"2021","journal-title":"Arthrosc Tech"},{"issue":"12","key":"ref26","doi-asserted-by":"crossref","first-page":"e1985","DOI":"10.1016\/j.eats.2020.08.033","article-title":"Arthroscopic identification of the knee posterolateral corner structures and anatomic arthroscopic posterolateral corner reconstruction: technical note\u2014part 2","volume":"9","author":"B Freychet","year":"2021","journal-title":"Arthrosc Tech"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s00402-021-03864-6","article-title":"Arthroscopic anatomy of the posterolateral corner of the knee: anatomic relations and arthroscopic approaches","volume":"142","author":"J Frings","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1177\/036354659702500403","article-title":"Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability","volume":"25","author":"R F LaPrade","year":"1997","journal-title":"Am J Sports Med"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"T K Koo","year":"2016","journal-title":"J Chiropr Med"},{"issue":"11","key":"ref30","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1007\/s00167-013-2537-5","article-title":"Influence of knee flexion angle and weight bearing on the tibial tuberosity-trochlear groove (TTTG) distance for evaluation of patellofemoral alignment","volume":"22","author":"K Izadpanah","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"07","key":"ref31","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1007\/s00167-014-3087-1","article-title":"Part II: the 50\u00b0\/60\u00b0 fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model","volume":"23","author":"J F Wechter","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.arthro.2019.12.023","article-title":"Editorial commentary: posterolateral corner reconstruction: is better (anatomy) the enemy of good?","volume":"36","author":"C K Schillhammer","year":"2020","journal-title":"Arthroscopy"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"2325967119838251","DOI":"10.1177\/2325967119838251","article-title":"A biomechanical comparison of the Arciero and LaPrade reconstruction for posterolateral corner knee injuries","volume":"7","author":"G P Treme","year":"2019","journal-title":"Orthop J Sports Med"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.arthro.2020.01.030","article-title":"Editorial commentary: shedding light on the posterolateral corner of the knee: can we do it with the scope? Is there a real benefit?","volume":"36","author":"J Chahla","year":"2020","journal-title":"Arthroscopy"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1177\/0363546513492704","article-title":"Neurovascular anatomic relationships to arthroscopic posterior and transseptal portals in different knee positions","volume":"41","author":"K G Makridis","year":"2013","journal-title":"Am J Sports Med"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1748897.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T01:51:17Z","timestamp":1687571477000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1748897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,7]]},"references-count":35,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2023,6,23]]},"published-print":{"date-parts":[[2023,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1748897","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,7]]}}}