Posterolateral corner injuries: Difference between revisions

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'''Posterolateral Corner Injuries''' of the knee are complex injuries that involve damage to the posterolateral corner (PLC) structures, which are crucial for stabilizing the knee against varus force, external rotation, and posterior translation. The PLC is composed of various ligaments, tendons, and muscles, including the [[lateral collateral ligament]] (LCL), the popliteus tendon, the popliteofibular ligament, and the biceps femoris tendon. These injuries often occur in conjunction with other knee injuries, such as [[anterior cruciate ligament]] (ACL) or [[posterior cruciate ligament]] (PCL) tears.


==Etiology==
{{Infobox medical condition
Posterolateral corner injuries are typically the result of a traumatic event, such as a sports injury, motor vehicle accident, or a fall. The mechanism of injury usually involves a direct blow to the anteromedial knee, hyperextension, or a severe varus force. Athletes participating in contact sports like football, soccer, and skiing are at a higher risk of sustaining these injuries.
| name            = Posterolateral corner injuries
 
| synonyms        = PLC injuries
==Clinical Presentation==
| specialty        = [[Orthopedic surgery]]
Patients with PLC injuries often present with pain and swelling in the posterolateral aspect of the knee, instability, and difficulty walking. A feeling of the knee giving way, especially when navigating turns or twisting movements, is common. Physical examination may reveal varus instability, increased external rotation, and a positive posterolateral drawer test.
| symptoms        = [[Knee pain]], [[instability]], difficulty with [[knee flexion]] and [[extension]]
 
| onset            = Acute or chronic
==Diagnosis==
| duration        = Varies, depending on severity and treatment
Diagnosis of posterolateral corner injuries involves a thorough clinical examination and imaging studies. [[Magnetic resonance imaging]] (MRI) is the gold standard for visualizing the extent of the injury and assessing any associated injuries to the cruciate ligaments or menisci. Stress radiographs can also be useful in evaluating the degree of lateral and rotational instability.
| causes          = [[Trauma]], [[sports injuries]], [[motor vehicle accidents]]
 
| risks            = [[Contact sports]], [[previous knee injuries]]
==Treatment==
| diagnosis        = [[Physical examination]], [[MRI]], [[stress radiography]]
The treatment of PLC injuries depends on the severity of the injury and the presence of concomitant knee injuries. Non-operative treatment, including physical therapy and bracing, may be considered for isolated, mild injuries. However, surgical intervention is often required for moderate to severe injuries or when other ligamentous injuries are present. Surgical techniques aim to repair or reconstruct the damaged structures to restore stability to the knee.
| differential    = [[Anterior cruciate ligament injury]], [[medial collateral ligament injury]], [[meniscus tear]]
 
| treatment        = [[Physical therapy]], [[surgical reconstruction]]
==Rehabilitation==
| prognosis        = Good with appropriate treatment
Rehabilitation following PLC injury is crucial for a successful recovery, whether the treatment is operative or non-operative. The rehabilitation program typically includes exercises to restore range of motion, strengthen the muscles around the knee, and gradually return to functional activities. The duration of rehabilitation varies depending on the severity of the injury and the type of treatment received.
| frequency        = Relatively uncommon compared to other knee injuries
 
}}
==Prognosis==
The [[posterolateral corner]] (PLC) of the knee is a complex anatomical region that provides stability to the knee joint, particularly against varus and external rotation forces. Injuries to the PLC can lead to significant instability and dysfunction of the knee, often requiring surgical intervention for optimal recovery.
The prognosis for patients with posterolateral corner injuries varies. With appropriate treatment and rehabilitation, many patients can return to their previous level of activity. However, the presence of concomitant knee injuries and the severity of the PLC injury can affect the overall outcome. Early diagnosis and treatment are important to minimize the risk of long-term instability and degenerative changes in the knee.
== Anatomy ==
 
The posterolateral corner of the knee consists of several key structures, including the [[fibular collateral ligament]] (FCL), the [[popliteus tendon]], and the [[popliteofibular ligament]]. These structures work together to stabilize the knee against varus and external rotation forces.
[[Category:Knee injuries and disorders]]
=== Fibular Collateral Ligament ===
 
The fibular collateral ligament, also known as the lateral collateral ligament, is a critical stabilizer of the knee. It originates from the lateral epicondyle of the femur and inserts onto the head of the fibula.
{{Orthopedic-stub}}
=== Popliteus Tendon ===
== Posterolateral_corner_injuries ==
The popliteus tendon is a key dynamic stabilizer of the posterolateral corner. It originates from the lateral femoral condyle and inserts onto the posterior surface of the tibia.
<gallery>
=== Popliteofibular Ligament ===
File:Tibial_and_Femoral_PLC_Attachments.jpg|Tibial and Femoral PLC Attachments
The popliteofibular ligament extends from the popliteus tendon to the fibular head, providing additional stability to the posterolateral corner.
File:Biceps_Femoris_Insertions_MRI.jpg|Biceps Femoris Insertions MRI
== Mechanism of Injury ==
File:Recurvatum_Test.jpg|Recurvatum Test
Injuries to the posterolateral corner often occur due to high-energy trauma, such as motor vehicle accidents or sports-related injuries. Common mechanisms include hyperextension, varus stress, and external rotation of the knee.
File:Varus_Stress_Test.jpg|Varus Stress Test
== Clinical Evaluation ==
File:Posterolateral_Drawer_Test.jpg|Posterolateral Drawer Test
A thorough clinical evaluation is essential for diagnosing PLC injuries. Several physical examination tests can help assess the integrity of the posterolateral corner.
File:Reverse_Pivot_Shift_Test.jpg|Reverse Pivot Shift Test
=== Recurvatum Test ===
File:Anatomic_FCL_Reconstruction.jpg|Anatomic FCL Reconstruction
The recurvatum test assesses for hyperextension and external rotation of the knee, which may indicate PLC injury.
File:Anatomic_Popliteus_Reconstruction.jpg|Anatomic Popliteus Reconstruction
=== Varus Stress Test ===
File:Anatomic_PLC_Reconstruction.jpg|Anatomic PLC Reconstruction
The varus stress test evaluates the integrity of the fibular collateral ligament by applying a varus force to the knee.
</gallery>
=== Posterolateral Drawer Test ===
The posterolateral drawer test assesses the stability of the posterolateral corner by applying a posterior force to the tibia while the knee is flexed.
=== Reverse Pivot Shift Test ===
The reverse pivot shift test evaluates the dynamic stability of the posterolateral corner by assessing for a clunk or shift as the knee is extended from a flexed position.
== Treatment ==
Treatment of posterolateral corner injuries depends on the severity of the injury and the presence of associated ligamentous injuries. Surgical reconstruction is often required for significant injuries.
=== Surgical Reconstruction ===
Surgical reconstruction of the posterolateral corner aims to restore the normal anatomy and function of the knee. Techniques may include reconstruction of the fibular collateral ligament and popliteus tendon.
== Rehabilitation ==
Rehabilitation following PLC injury or surgery is crucial for restoring knee function. It typically involves a structured physical therapy program focusing on range of motion, strength, and proprioception.
== Related Pages ==
* [[Knee joint]]
* [[Ligamentous injuries of the knee]]
* [[Knee surgery]]
[[Category:Orthopedic injuries]]
[[Category:Knee]]

Latest revision as of 04:39, 4 April 2025


Posterolateral corner injuries
Synonyms PLC injuries
Pronounce N/A
Specialty Orthopedic surgery
Symptoms Knee pain, instability, difficulty with knee flexion and extension
Complications N/A
Onset Acute or chronic
Duration Varies, depending on severity and treatment
Types N/A
Causes Trauma, sports injuries, motor vehicle accidents
Risks Contact sports, previous knee injuries
Diagnosis Physical examination, MRI, stress radiography
Differential diagnosis Anterior cruciate ligament injury, medial collateral ligament injury, meniscus tear
Prevention N/A
Treatment Physical therapy, surgical reconstruction
Medication N/A
Prognosis Good with appropriate treatment
Frequency Relatively uncommon compared to other knee injuries
Deaths N/A


The posterolateral corner (PLC) of the knee is a complex anatomical region that provides stability to the knee joint, particularly against varus and external rotation forces. Injuries to the PLC can lead to significant instability and dysfunction of the knee, often requiring surgical intervention for optimal recovery.

Anatomy[edit]

The posterolateral corner of the knee consists of several key structures, including the fibular collateral ligament (FCL), the popliteus tendon, and the popliteofibular ligament. These structures work together to stabilize the knee against varus and external rotation forces.

Fibular Collateral Ligament[edit]

The fibular collateral ligament, also known as the lateral collateral ligament, is a critical stabilizer of the knee. It originates from the lateral epicondyle of the femur and inserts onto the head of the fibula.

Popliteus Tendon[edit]

The popliteus tendon is a key dynamic stabilizer of the posterolateral corner. It originates from the lateral femoral condyle and inserts onto the posterior surface of the tibia.

Popliteofibular Ligament[edit]

The popliteofibular ligament extends from the popliteus tendon to the fibular head, providing additional stability to the posterolateral corner.

Mechanism of Injury[edit]

Injuries to the posterolateral corner often occur due to high-energy trauma, such as motor vehicle accidents or sports-related injuries. Common mechanisms include hyperextension, varus stress, and external rotation of the knee.

Clinical Evaluation[edit]

A thorough clinical evaluation is essential for diagnosing PLC injuries. Several physical examination tests can help assess the integrity of the posterolateral corner.

Recurvatum Test[edit]

The recurvatum test assesses for hyperextension and external rotation of the knee, which may indicate PLC injury.

Varus Stress Test[edit]

The varus stress test evaluates the integrity of the fibular collateral ligament by applying a varus force to the knee.

Posterolateral Drawer Test[edit]

The posterolateral drawer test assesses the stability of the posterolateral corner by applying a posterior force to the tibia while the knee is flexed.

Reverse Pivot Shift Test[edit]

The reverse pivot shift test evaluates the dynamic stability of the posterolateral corner by assessing for a clunk or shift as the knee is extended from a flexed position.

Treatment[edit]

Treatment of posterolateral corner injuries depends on the severity of the injury and the presence of associated ligamentous injuries. Surgical reconstruction is often required for significant injuries.

Surgical Reconstruction[edit]

Surgical reconstruction of the posterolateral corner aims to restore the normal anatomy and function of the knee. Techniques may include reconstruction of the fibular collateral ligament and popliteus tendon.

Rehabilitation[edit]

Rehabilitation following PLC injury or surgery is crucial for restoring knee function. It typically involves a structured physical therapy program focusing on range of motion, strength, and proprioception.

Related Pages[edit]

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