Table 1.

Summary of Surgical Steps

1.Confirm diagnosis with examination under anesthesia. 2.Mark the surgical approach. 3.Arthroscopic retrieval of the popliteus tendon using sutures placed with a scorpion and guidewire. 4.Make 3 fascial incisions: The first is posterior to the biceps tendon, exposing and protecting the peroneal nerve. The second identifies the lateral collateral ligament (LCL) insertion. The third allows for iliotibial band (ITB) tenodesis while preserving the ITB. 5.Create an anterolateral-to-posteromedial transfibular tunnel. 6.Identify the arthroscopically sutured popliteus tendon and its attachment site. 7.Drill 2 femoral socket tunnels, 18.5 mm apart, using a reamer with a diameter equivalent to the graft. 8.Shuttle the graft through the fibular tunnel, then into the anterior and posterior femoral sockets, representing the LCL and popliteofibular limbs, with the knee in 30° flexion and slight valgus force. 9.Secure the graft by placing bioabsorbable interference screws in both femoral sockets, anchoring both sides of the graft. 10.Perform side-to-side repair of the popliteus tendon with the popliteofibular graft at the exit of the trans-fibular tunnel. 11.Perform extra-articular ITB tenodesis to reinforce the reconstruction.