CLINICS 2012;67(6):597-602 New autografts in PLC lesions Oliveira MG et al. Figure 3 - A surgical planning illustration showing the tunnels in relation to the isometric points. Popliteofibular ligament and popliteus tendon – the tibial insertion of the popliteus tendon was made through an anterior-posterior tunnel, 5 mm below the center point of Gerdy’s tubercle, with a 7-mm drill, ending 15 mm from the intra-articular line in the posterior region of the tibia. The common femoral insertion was made 5 mm anterior and distal to the midpoint of the lateral femoral epicondyle, with a diameter of 7 mm and a depth of 2.5 cm. The fibular insertion of the popliteofibular ligament was made through an anteroposterior tunnel, with a diameter of 5 mm (Figure 5), 1 cm below the fibular styloid. Before fixing the grafts, 25 cycles of pre-tensioning were conducted with 0 to 110 degrees of knee flexion. The graft fixation in the bone tunnels was performed with titanium interference screws with the knee in 30 degrees of flexion and internal valgus rotation. Finally, the suture was made, plane by plane. Postoperative care The lower limb of the patient was kept in a splint in extension for four weeks. Subsequently, the rehabilitation program began. The patient was released to passive, assisted physiotherapy, with the knee being flexed gradually from 0 to 90 degrees after four weeks of cast immobilization. After the removal of the splint, a period of four weeks of other isometric exercises was recommended, always with partial loading. After the knee was no longer immobilized, it was kept in a hinged brace for protection of the collaterals. Eight weeks after the surgery, full loading was allowed, and the knee could be flexed beyond 90 degrees. The isometric exercises were maintained. Strength exercises were allowed (for strengthening and endurance, gradually) after 12 weeks, and running is allowed after 20 weeks. The patient was discharged nine months postoperatively. Figure 4 - A surgical planning illustration showing the grafts through the tunnels; collateral fibular ligament (LCF), popliteus tendon (TP) and popliteofibular ligament (LPF). Statistical analysis The qualitative variables are presented in terms of absolute and relative frequencies. For the quantitative variables, summary statistics (mean and standard deviation, for example) and boxplot graphs are presented. To compare the total Lysholm scores between the two evaluation times, the paired Student’s t test was used. The comparison of the ligament evaluations (IKDC item 4) between the pre- and post-surgery times is demonstrated by descriptive tables. The level of significance was set at 5%. RESULTS Of the 129 patients operated on and included in the study, 94.6% were male (122 patients). The right side was affected in 58.9% of the patients (76 patients). The patients’ ages ranged from 16 to 55 years, with a mean age of 30 years and 11 months. The causes of injury were major motor vehicle accidents in 54 cases, 52 of which involved motorcycle accidents. Sports were the cause of injury in 54 patients (soccer in 52 cases). The other 21 patients were injured in other accidents. The time between injury and surgery 599 Figure 5 - Preparation of the tunnels.