Combined anterolateral posterolateral rotary instability: Is posterolateral complex reconstruction necessary?

Background: the treatment of combined anterolateral posterolateral rotary instability has been done by correctingknee alignment, anterior cruciate ligament (acl) reconstruction plus repair or reconstruction of the posterolateral complex.because of the technical difficulties encountered in these operations and the need for more than two stages, andconsidering the controversy among the role of posterolateral complex (plc) in valgus knees, this study was designed toobserve the results of treating this instability by acl-reconstruction alone, after correction of varus, without reconstructionof the posterolateral complex or further extra-articular manipulation.methods: this was a clinical trial performed on 29 patients (29 knees) with combined anterolateral posterolateral rotaryinstability. subjective and objective instability signs were recorded. arthroscopy was then performed and a valgusosteotomy was done to correct alignment. then in a second stage, an acl-reconstruction was carried out. results, aftera mean of 23 months follow-up, were compared to the conditions before surgery. fisher exact test, x2 and wilcoxontests were used to analyze the data . p<0.05 was considered to be meaningful.results: pain was relieved in more than half and locking was improved in all of the patients. giving way of the kneewas diminished from 79.3% to 6.9%. special instability tests showed a significant improvement after surgery(p