Posterolateral corner injuries

Injuries to the posterolateral corner of the knee

Posterolateral Corner Injuries

The posterolateral corner (PLC) of the knee joint is a complex anatomical region that provides stability to the knee, particularly against varus and external rotational 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 is composed of several key structures:

• Lateral collateral ligament (LCL): A primary stabilizer against varus forces.
• Popliteus muscle and tendon: Provides dynamic stability and assists in controlling external rotation of the tibia.
• Popliteofibular ligament: Connects the popliteus tendon to the fibula, providing additional stability.
• Arcuate ligament complex: Includes the arcuate ligament, fabellofibular ligament, and other associated structures.

These structures work in concert to stabilize the knee during movement and protect against excessive varus and rotational forces.

Mechanism of Injury

PLC injuries often occur due to high-energy trauma, such as motor vehicle accidents or sports-related injuries. Common mechanisms include:

• Direct blow to the anteromedial knee: This can cause a varus force, stressing the PLC.
• Hyperextension injuries: Often seen in contact sports.
• Rotational injuries: Excessive external rotation can damage the PLC structures.

Clinical Presentation

Patients with PLC injuries typically present with:

• Pain and swelling: Localized to the lateral aspect of the knee.
• Instability: Particularly with varus stress or during activities requiring pivoting.
• Difficulty with ambulation: Due to instability and pain.

Diagnosis

Diagnosis of PLC injuries involves a combination of clinical examination and imaging studies:

• Physical examination: Tests such as the varus stress test, dial test, and reverse pivot shift test can help assess PLC integrity.
• Imaging: Magnetic resonance imaging (MRI) is the gold standard for visualizing soft tissue injuries in the PLC.

Treatment

Treatment options for PLC injuries depend on the severity of the injury:

• Non-surgical management: May be appropriate for low-grade injuries and involves physical therapy and bracing.
• Surgical intervention: Required for high-grade injuries or when there is significant instability. Surgical options include repair or reconstruction of the damaged structures.

Rehabilitation

Rehabilitation following PLC injury or surgery is crucial for optimal recovery:

• Early phase: Focuses on reducing swelling and restoring range of motion.
• Intermediate phase: Strengthening exercises for the quadriceps, hamstrings, and hip muscles.
• Advanced phase: Functional training and sport-specific drills to prepare for return to activity.

Prognosis

The prognosis for PLC injuries varies based on the severity of the injury and the treatment approach. Early diagnosis and appropriate management are key to achieving good outcomes.

Related pages

• Knee joint
• Ligament injuries
• Orthopedic surgery

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• Biceps Femoris Insertions MRI
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• Recurvatum Test
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• Varus Stress Test
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• Posterolateral Drawer Test
  Posterolateral Drawer Test
• Reverse Pivot Shift Test
  Reverse Pivot Shift Test
• Anatomic FCL Reconstruction
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• Anatomic Popliteus Reconstruction
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• Anatomic PLC Reconstruction
  Anatomic PLC Reconstruction