**6. Discussion**

More and more orthopedic surgeons are familiar with treatment of multiligament knee injuries [25]. Last two decades brought a great development in *Injuries of the Posterolateral Corner of the Knee-Diagnosis and Treatment Options for Beginning… DOI: http://dx.doi.org/10.5772/intechopen.99219*

#### **Figure 13.** *Fixation of gracilis tendon graft in fibular head using interference screw.*

understanding of anatomy, function and biomechanics not only of central knee structures like ACL, PCL and menisci, but also for so-called "knee corners" including PLC and PMC. That has put more interest on rotatory instabilities of the knee and caused introduction of many surgical techniques to address them [1–25]. A lot of surgical techniques were published, however only few presented results, what outlines the fact that objective measurement of rotatory knee stability remains difficult. Currently, reported results include patient subjective outcome scores, clinical examination findings and stress X-ray findings [21]. Each study presented significant increase in Lysholm score and International Knee Documentation Committee score and improvement in clinical exam after surgery [21]. However, it is worth noting that all these factors are subjective and at risk of bias. More objective factor, a stress X-ray, which allows to measure lateral joint line opening or posterior tibial translation, may be useful, but only in more complicated PLC injury patterns, usually with concomitant injuries. The "gray-zone" remain an isolated grade A or B posterolateral rotatory instabilities, where reporting of objective results is difficult. The solution may be a biomechanical cadaveric study. However, as it was previously said, overall success rate in PLC reconstructions may reach about 90% [21]. It depends, among others, on indications and techniques, which were applied. In cases of any doubt, expert consensus statement from 2019 is helpful to make a proper decision about treatment.

Most advantages and disadvantages of open and arthroscopic procedures were explained earlier in this chapter. A shift toward arthroscopic procedures was also outlined. Previously described reasons inspired senior authors (K.H, P.J) to develop arthroscopic PLT tenodesis and arthroscopic-assisted PLC reconstruction, which have been used by our team for many years. Indications, advantages and disadvantages of presented technique were described in detail. These methods meet with high patients satisfaction rate, significant improvement in clinical examination may be observed, thus in our opinions they are effective in treatment of PLRI, however studies on objective results lasts.
