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postero-lateral corner and ACl

Question: postero-lateral corner and ACl

I have a new skiing injury: a torn acl, mri also showed a trabecular tibial fracture which was interpreted as a bone bruise and a posterolateral corner injury, with intact PCL. if my pcl is intact, what is injured in my posterolateral corner? are there any precautions that I need to take in my acl rehab to protect this posterolateral corner? thanks

Answer:

Hi,

the posterior lateral corner can be injured in conjunction with a acl or pcl injury and also in isolation (rare). The posterior lateral corner is a complex of many different components. It generally is responsible for resisting posterior translation of the tibia on femur, external rotation of the tibia on the femur and varus stress (stress to the outside structures of the knee).

The major structures of the posterolateral corner of the knee include the iliotibial tract, the lateral collateral ligament, the popliteus complex consisting of both dynamic components (the popliteus muscle-tendon unit) and static components (the popliteofibular ligament), the middle third of the lateral capsular ligament, the fabellofibular ligament, the arcuate ligament, the posterior horn of the lateral meniscus, the lateral coronary ligament, and the posterolateral part of the joint capsule.

As you can see the posterior lateral corner is quite complex and made up of many structures, any one of which may be injured. Rehab should concentrate on strengthening the surrounding musculature, while avoiding stressing this complex i.e. avoiding combinations of external rotation, and stress to the lateral side (varus) of the knee. Rehab should be overseen by an experienced physio in this case.

Hope some of this helps.