Abstract

PurposeAlthough complete tear of the knee posterolateral corner (PLC) commonly occurs in combination with other knee ligamentous injuries, the incidence of isolated PLC injury was reported only 28% and overlooked in many cases. Nevertheless, an isolated PLC injury does not only provoke posterolateral instability, but also may be associated to hypermobile lateral meniscus. This study aims at showing the characteristics of isolated PLC injuries and to alert potential overlooked cases by describing their arthroscopic findings and clinical characteristics.MethodsSeventy-one patients with a clinically proven isolated PLC injury who underwent knee arthroscopy were included in this study. Pre-operative symptoms and clinical signs at examination were recorded: Pain at the posterolateral aspect, feelings of instability, catching, locking; and for clinical signs: McMurray test, varus stress test in extension and at 30° of flexion, posterolateral drawer test at 30° and 80°, dial test at 30° and 80° of flexion. In terms of arthroscopic findings, systematic meniscal stability was performed to evaluate the presence of hypermobile lateral meniscus, “lateral drive through test” was also recorded in all cases.ResultsPositive Lateral Drive through test was found in 69 patients (95.8%). Hypermobile lateral meniscus was seen in all patients.ConclusionsHyper mobile lateral meniscus was concomitant with all isolated PLC injuries in our case series. As the typical arthroscopic characteristic, lateral drive through test positive were seen in 95.8%. In order to prevent overlooking this concomitant pathology, meticulous arthroscopic observation is crucial.Level of evidenceLevel IV.

Highlights

  • The posterolateral corner (PLC) of the knee is the main restraint to varus forces of the tibia relative to the femur [3]

  • During arthroscopy, a positive lateral drive through test was seen in 69/72 knees (95.8%)

  • The association between a positive lateral drive through test and PLC structures injury have been investigated by Feng et al in a cadaveric study

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Summary

Introduction

The posterolateral corner (PLC) of the knee is the main restraint to varus forces of the tibia relative to the femur [3]. In spite of this important function, there is still a limited understanding of the structures, biomechanics, and treatment option [4, 7, 25]. Stabilizers of the PLC include the lateral collateral ligament (LCL), the popliteus tendon (PT), the popliteofibular ligament (PFL), Goto et al Journal of Experimental Orthopaedics Classification Scale of damage. 10° increase in external rotation of the tibia. Slight varus relaxation (5–10 mm increase in varus load test) LCL Type C

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