When an athlete ruptures the ACL or PCL in the knee, there is a risk for a posterolateral corner injury. This is more common in contact injuries, or with a force applied to the anteromedial aspect of the tibia. When the posterolateral corner is injured, it can affect the stability of the knee and have poorer long term outcomes if not addressed.
The posterolateral corner is composed of the LCL, popliteus tendon, capsule, biceps femoris tendon and lateral gastrocnemius tendon. An injury to this area results in tearing or those structures that cause the tibia to sublux posterior to the femur.
When assessing the knee, and the posterolateral corner, look for an increase in external rotation at 30 degrees of flexion. You can also assess for rotary instability of the knee or for posterior displacement by abducting the hip and externally rotating the tibia. A depression over the lateral aspect would lend credence to the involvement of the posterolateral corner.
Injuries to this area can result in greater instability of the knee. Even if the cruciates are reconstructed, leaving the posterolateral corner can result in graph failures and early onset of OA and degeneration of the menisci. There are different surgical approaches to fixing the posterolateral corner that would involve discussion with a surgeon.
When assessing your athletes with a suspicious mechanism, remember to check out whether the posterolateral corner is involved to aid in treatment and rehabilitation decisions.
The Posterior Cruciate Ligament Injuries is most commonly injured when an athlete receives a blow to the front of the knee.
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