Posterolateral Corner Knee Injuries
What is a Posterolateral Corner?
The posterolateral corner is a complex located behind the knee that is primarily composed of the LCL, popliteus tendon, and the popliteofibular ligament. [1, 2]
This complex is commonly injured in conjunction with ACL or PCL injuries, since they involve the same mechanisms of injury. [1, 2] Posterolateral corner injuries can also occur in isolation of other knee ligament injuries, especially in athletes such as soccer goalkeepers who are often in positions where the posterolateral corner is vulnerable. [1]
Posterolateral Corner Assessment
Posterolateral corner injuries are diagnosed through a combination of clinical tests that are specific to compromising the posterolateral corner structures. The varus stress test, dial test, and the posterolateral drawer test are among a battery of clinical assessments that can be performed by a physiotherapist to accurately diagnose this injury. [2]
Upon diagnosis the posterolateral corner injuries can then be classified into 3 grade levels based on the Hughston grading scale. [1, 2] These grades will determine the severity and rough prognosis of the injury. Although surgical management is indicated for grade 3 (complete rupture) type injuries, conservative physiotherapy management has been shown to be effective for lower grade (1-2) injuries. [1]
Posterolateral Corner Management
Early hinged brace immobilization is used to encourage optimal healing of the damaged tissues. [1, 2] Physiotherapy management will primarily focus on pain and swelling reduction in the early stages, as well as gradual strengthening programs to address the any muscle deficits above or below the knee joint. [1,2]
If you have any questions regarding posterior knee pain or think you may benefit from physiotherapy, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.
References
Ranawat, A. L., Baker, C. D., Henry, S., & Harner, C. (2008). Posterolateral Corner Injury of the Knee: Evaluation and Management. Journal of the American Academy of Orthopaedic Surgeons, 16(8), 506-518.
Bonanzinga T, Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Neri MP, Marcacci M. Management of Combined Anterior Cruciate Ligament-Posterolateral Corner Tears: A Systematic Review. Am J Sports Med. 2014;42(6):1496-503.