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From the American Academy of Orthopaedic Surgeons

Knee Ligament Injuries

Posterior Cruciate Ligament (PCL) Tear

Posterolateral Corner Injuries
by Robert F. LaPrade, MD

Posterolateral corner injuries are defined to be an injury of the structures on the lateral and posterolateral aspect of the knee which contribute to an increased amount of varus, external rotation, and/or coupled posterior drawer and external rotation of the knee. Most posterolateral corner knee injuries are due to blows to the anteromedial aspect of the knee, contact and noncontact hyperextension injuries, and varus contact injuries to a flexed knee. The overall incidence of isolated posterolateral corner injuries is between 20% and 30%, with a majority of these occurring in combination with either an anterior cruciate ligament and/or posterior cruciate ligament 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.

This article reviews the pathophysiology and clinical presentation for paterolateral corner injuries and reviews indications and contraindications for nonsurgical and for surgical treatment. The article also reviews the surgical technique of posterolateral corner reconstruction in detail. Video is available.

Keywords: knee injury, incidence, mechanism of injury, etiology, classification, diagnosis, patient history, physical examination, external rotation recurvatum test, varus stress test, dial test, posterolateral drawer test, Lachman test, reverse pivot shift test, gait analysis, imaging, radiography, MRI, differential diagnosis, management, nonsurgical treatment, surgical treatment, surgical techniques, posterolateral corner reconstruction, indications, contraindications, outcomes, rehabilitation, complications

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