Posterolateral Corner Injuries With Associated Ligament Injuries Of The Knee: A Retrospective Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 2
Abstract
Background: Posterolateral corner of knee consists of a number of static and dynamic restraints. Static restraints are the lateral collateral ligament, arcuate ligament, fabellofibular ligament, popliteofibular ligament, joint capsule and coronary ligaments.Dynamic restraints are biceps femoris and popliteus muscle tendon units. Aim of this study is to emphasize on early recognition of injury to the posterolateral corner and to assess the interval between the injury and diagnosis in patients with this injury.Materials and Methods:Hospital records of 75 patients who had been referred with suspected posterolateral corner injury of the knee were reviewed between June 2013 – June 2016 at St. John’s Medical College Hospital, Bangalore. These injuries were diagnosed based on a combination of clinical assessment, imaging and arthroscopy. Results:56 patients (75%) presented within 24 hours of injury with mean presentation at 5 days (Range 0-15) after the injury. There was a mean delay to the diagnosis of injury to the posterolateral corner of 25 months (Range 0-300) from the time of injury. Injuries in 54 patients (72%) were not identified at the time of initial presentation, with the injury to the posterolateral corner only recognized in patients who had multiple ligamentous injuries. The correct diagnosis, including injury to the posterolateral corner, had only been made in 38 patients (50%) at the time of referral. MRI correctly identified 19/20 cases when performed within 12 weeks of injury. Discussion: Injury to the posterolateral corner of the knee frequently remains overlooked. Reasons for not diagnosing this injury include, failure to perform appropriate clinical examination, using tests with low sensitivity, poor training in the assessment of ligament laxity and failure to get MRI done. In our study, the most common mechanism of injury was a non-contact twisting injury. Conclusion: Our study focusses on the need for examination and investigation of acute ligamentous injuries at the knee with symptoms of instability.
Authors and Affiliations
Ashok Alapati, Reddy Ravikanth, Rajkumar S Amravathi
Keywords
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