Posterolateral instability of the knee

Abstract

Posterolateral instability of the knee is difficult to diagnose and treat. It has been attributed to failure of ligament reconstruction and has been the cause of numerous knee operations. We present a small group of patients who complained of giving way of the knee and who had an increased range of external rotation of the tibia at 90 degrees knee flexion. The patients all had similar symptoms. We describe the standing apprehension test, which was positive in every case. Anterior subluxation of the lateral femoral condyle was detected manually in four patients and confirmed by radiography and MRI in one. The medial knee pain which is often associated with episodes of instability is probably due to stretching of the posteromedial soft tissues and perhaps the saphenous nerve.

Changes in ankle joint alignment after proximal fibular osteotomy

“…The fibular is an important structure in maintaining the balance of the periarticular soft tissue and supports one-sixth of body weight [ 11 ]. The PFO can be explained by the theory of non-uniform-settlement in the treatment of medial compartment KOA [ 5 ].…”

“…There have been researches focusing on the correlation of ankle and knee joints after the treatment with HTO, but no consensus are concluded. Takeuchi reported the successful treatment to osteoarthritis of ipsilateral knee and ankle joints with HTO [ 11 ]. They found that the tilt of ankle joint as well as the varus deformity of knee joint was improved after HTO, and suggested HTO was one of the effective methods in treating medial compartment osteoarthritis of knee and ankle on the same leg.…”

Biomechanical and Anatomical Assessment after Knee Hyperextension Injury

“…19 Also, one mechanism of injury to the posterolateral corner of the knee has been reported to be a posteriorly directed force on the anteromedial aspect of the knee, causing hyperextension. 5,8,9,13,27…”

“…The mechanism of injury has been reported to be a posteriorly directed force on the anteromedial aspect of the knee causing hyperextension or a twisting injury resulting in external rotation of the knee. 5,8,9,13,27 Unrecognized and untreated injuries of the posterolateral corner can lead to ACL and PCL graft failure. 7,18,28 Harner et al 7 showed an improved outcome with combined PCL and posterolateral corner repair versus only PCL repair.…”

Using three-dimensional isotropic SPACE MRI to detect posterolateral corner injury of the knee

“…Injuries of the PLC are uncommon among acute ligamentous injuries about the knee, but their diagnosis is important because they can result in considerable morbidity (1). Such injuries are rarely isolated events and are often associated with concomitant injury to a cruciate ligament, particularly the posterior cruciate ligament (PCL) (1)(2)(3)(4)(5)(6)(7). Furthermore, failure to recognize PLC injury after cruciate ligament reconstruction can lead to graft failure (5,(8)(9)(10), and an overlooked PLC injury can cause chronic pain and eventually result in osteoarthritis (5).…”