Physical examination of patients with a suspected posterolateral corner injury must be comprehensive. Mechanical alignment, gait, and any hyperextension or varus thrust should all be evaluated. The status of all ligaments of the knee also must be thoroughly assessed. Detecting the presence or absence of a PCL can be difficult but is essential (Table). The dial test is easy to perform and is the most standard and accepted test to assess and follow posterolateral rotatory instability of the knee.
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Introduction: Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. This is the first report describing a wholly tibial-based PLC reconstruction.
Case Report: A 50-year-old female presented with knee instability following proximal fibular resection for a benign tumor, associated with chronic anterior cruciate ligament (ACL) deficiency from a previous injury.
Posterolateral Corner Reconstruction: A Systematic Review and Meta-analysis of Biomechanical Studies.
Am J Sports Med
January 2025
MedStar Orthopaedic Institute, Union Memorial Hospital, Baltimore, Maryland, USA.
Background: Surgical reconstruction is the standard treatment for injuries to the posterolateral corner (PLC) of the knee and can be performed using either a fibular-based or combined tibiofibular-based technique. Although some comparative studies have been performed, there is no consensus regarding the reconstructive approach that confers optimal biomechanical properties of the PLC.
Purpose: To perform a systematic review and meta-analysis to evaluate the biomechanical properties of the knee after PLC reconstruction with fibular-based and tibiofibular-based techniques.
With an estimated incidence of 0.02% to 0.2%, multiligamentous knee injuries are rare, often devastating injuries that can occur with concomitant vascular or neurologic involvement.
View Article and Find Full Text PDFPosterolateral Knee Ligament Reconstruction Using the Arciero Technique Provides Greater Rotational Stability Than the Modified Larson Technique: A Biomechanical Study.
Am J Sports Med
January 2025
Department of Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria.
Background: It is still unknown if the double-femoral tunnel technique (Arciero [ARC]) provides better stability as compared with the single-femoral tunnel technique (modified Larson [LAR]) in posterolateral corner reconstruction. The ideal angle of fixation of the popliteofibular strand in ARC is also unknown.
Hypotheses: The ARC provides greater external rotation (ER) stability than the LAR (hypothesis 1); there is no difference in varus rotation (VR) stability between LAR and ARC (hypothesis 2); and femoral fixation of the popliteofibular strand at 60° during the ARC leads to greater ER stability than fixation at 30° or 90° of knee flexion (hypothesis 3).
Repair of Acute Grade-3 Combined Posterolateral Corner Avulsion Injuries Using a Transosseous Krackow Suture Pull-Through Technique.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
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