Posterolateral corner injuries: Difference between revisions
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Revision as of 03:25, 9 March 2025
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
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
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
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
The popliteofibular ligament extends from the popliteus tendon to the fibular head, providing additional stability to the posterolateral corner.
Mechanism of Injury
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
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
The recurvatum test assesses for hyperextension and external rotation of the knee, which may indicate PLC injury.
Varus Stress Test
The varus stress test evaluates the integrity of the fibular collateral ligament by applying a varus force to the knee.
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.
