Restoring medial knee stability: A cadaveric comparison of three posteromedial reconstruction techniques - 13/12/25

Doi : 10.1016/j.otsr.2025.104558

Alexandre Santoli ^a, Charles Pioger ^b, Vincent Tambosco ^a, Vasileios Giovanoulis ^a, Pierre Alban Bouché ^c, Nicolas Pujol ^a,⁎

^a Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, Île-de-France Ouest University, 177 Rue de Versailles, 78150 Le Chesnay, France

^b Department of Orthopaedic Surgery, Ambroise Paré Hospital, Paris Saclay University, 9, Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France

^c Department of Orthopaedic Surgery, Lariboisière Hospital, Paris University, 2, rue Ambroise Paré, 75010 Paris, France

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 13 December 2025

Abstract

Introduction

Injuries to the posteromedial corner of the knee are common and often require surgical reconstruction. This cadaveric study aimed to compare three reconstruction techniques—Lind, LaPrade, and Versailles—in terms of valgus laxity control, as well as internal and external rotational stability.

Hypothesis

Authors hypothesized that the three posteromedial reconstruction techniques—Versailles, Lind, and LaPrade—would provide comparable restoration of valgus and rotational stability when performed anatomically.

Materials and methods

Fifteen cadaveric knees were tested to compare the three surgical techniques. Valgus laxity in full extension, external rotation at 30 ° (dial test), and internal rotation in extension were measured in three conditions: intact knee, after sectioning of the posteromedial corner and the medial collateral ligament (superficial and deep layers), and after anatomical posteromedial reconstruction using one of each technique.

Results

No significant differences in valgus laxity in full extension were found among the three techniques in the intact, sectioned knees, meaning that the specimens were comparable. After sectioning, valgus laxity increased significantly in all specimens from 6.92 mm to 12.98 mm for Lind, 6.52 mm–12.58 mm for Versailles, and 6.53 mm–12.3 mm for LaPrade. After reconstruction, valgus laxity was restored in all three groups without significant differences compared to the intact knee (p = 0.25), with values of −1.76 mm, −1.35 mm, and −1.16 mm for Lind, LaPrade, and Versailles techniques, respectively. Similarly, no significant differences were observed in external rotation at 30 ° or internal rotation in extension among the three groups: intact knee (p = 0.14, p = 0.47), sectioned state (p = 0.83, p = 0.36), and after reconstruction (p = 0.071, p = 0.17). External and internal rotational stability were restored without significant differences compared to the intact state (p = 0.11, p = 0.15).

Conclusion

Two anatomic reconstructions (Versailles, LaPrade) and one anatomy-aligned technique (Lind) achieved comparable restoration of valgus stability in extension and rotational control.