Posterolateral Corner Knee Injuries: An Uncommon but Disabling Injury

Most often I post on common knee issues using terms the non medical person can easily follow. However, today's post will deviate from using easily understood terms as I explain an uncommon but debilitating knee injury. This post will contain a lot of medical jargon

Modifying to some degree an excerpt from Orthopedics Knowledge On line by William Grana, M.D. "Posterolateral corner injuries are defined to be an injury of the structures on the posterolateral (and to a variable degree lateral) aspect of the knee which contribute to an increased amount of abnormal external rotation of the tibia on the femur making the patient feel their knee is unstable. Most posterolateral corner knee instabilities are the result of injuries such as blows to the anteromedial aspect of the knee, contact and noncontact hyperextension injuries, and varus contact injuries to a flexed knee. There is a very small group of patients that have this instability without any injury. Usually this instability is associated with complete tears of the ACL (anterior cruciate ligament) or PCL (posterior cruciate ligament) One in five of posterolateral corner injuries are isolated to the PL corner (no ACL or PCL injury) The main treatment options for posterolateral knee injuries depend upon the grade of instability (grade I through grade III), acute versus chronic injuries, functional deficits, and whether there are any other associated ligament injuries concurrent with the posterolateral corner injury.

Most patients that have the feeling that their knee is buckling on a regular basis need surgery to stabilize the knee. This surgery is not arthroscopic. The surgeon makes a 4-5 inch incision on the outside (lateral side) of the knee and routes a donor tendon thru the tibia, around the back corner of the knee and attaches the donor tendon onto the lateral femur. The knee is braced with limited motion for 2 months. Most patients fully recover and return to normal activities.

Here is a link with an extremely technical description of the problem with diagrams and pictures of the procedure - not for the feint of heart- http://www.orthosupersite.com/view.asp?rID=28404