**5.1 Indications and contraindications**

The indications for this complex procedure are grade B and C PLC injuries according to Fanelli and Larson classification, especially when varus instability requiring FCL reconstruction is presented and excessive tibial external rotation which cannot be treated with PLT tenodesis is observed [23].

The contraindications are excessive varus deformity, poor bone quality, advanced degenerative joint disease, rheumatoid arthritis, limited range of motion.
