20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

POSTEROLATERAL CORNER (PLC) SURGERY

The Posterolateral Corner (PLC) is a group of structures on the outside of the knee that provides the knee with rotational stability. The main anatomic structures of the posterolateral aspect of the knee are the lateral collateral ligament (LCL) the popliteus tendon, and the popliteofibular ligament. In patients who sustain a significant injury to one or all of the structures that make up the PLC, Dr. Keller usually recommends surgery.

The goal of PCL surgery is to stabilize the knee by preventing abnormal external rotation of the tibia bone and abnormal gapping on the outside of the knee (varus instability). Surgery involves reconstructing the structures of the PLC, usually with a hamstring allograft (donor tissue). There are multiple techniques for PLC reconstruction, and Dr. Keller typically employs a “fibular-based” technique, similar to the technique used for LCL reconstruction. During surgery, Dr. Keller makes an incision on the outside of the knee and identifies the spots on the femur bone and fibula bone where the torn structures should attach. Dr. Keller then creates bony “tunnels” at the appropriate positions. The donor tissue is then placed under appropriate tension and is fixed to the tunnels with medical screws.

Post-Operative Rehabilitation

Following surgery, patients are limited to a “safe zone” of knee motion based on findings during surgery. Dr. Keller recommends crutches and non weight-bearing on the affected leg for six weeks following surgery. Dr. Keller also recommends intermittent icing, straight leg raises for quad strength, and starting a dedicated physical therapy protocol two weeks after surgery. Physical therapy focuses on reducing swelling in the knee, restoring strength to the knee, and gradual return of range of motion. Dr. Keller recommends advancing the physical therapy program to cutting, pivoting, and sport-specific activities only after the patient has achieved certain goals (for example, appropriate quadriceps strength, appropriate range of motion, etc.). Most patients start sport-specific training approximately 4-6 months after surgery. Most patients return to competitive sports approximately six months after surgery. It is very important to follow the rehabilitation process carefully to achieve the best outcome.