The knee injury around the corner
What is the posterolateral corner and how might an injury to the corner affect you? Jon Smith explains.
You don’t have to be a knee surgeon to have an understanding of some anatomical terms for the knee. If you follow or play sport, chances are you’ll be familiar with ACL injuries and meniscal tears. And most of us probably know someone with osteoarthritis. But some parts of the knee enjoy a considerably lower profile, and one such is the posterolateral corner.
That’s somewhat surprising, because posterolateral (PLC) corner injuries account for a significant number of knee ligament injuries. They are also injuries that require a large degree of anatomical expertise. As Robert LaPrade, a world leader on the PLC, noted recently in his presentation at the Arthroscopy Association of North American and American Orthopaedic Society in Las Vegas, “surgeons who treat PLC injuries with anatomic reconstruction need to know the anatomy well because surgical time will decrease, the surgery will go better and motion can be initiated earlier.”
What is the PLC?
The posterolateral corner is a complex area of tendons and ligaments around the outside of the knee. Like a Spaghetti Junction of the body, the PLC is a ‘meeting point’ for the fibular collateral ligament, the popliteofibular ligament, the popliteus tendon, the biceps femoris tendon, the iliotobial band and more.
The PLC plays an important role in stabilising the knee. It resists a varus force – so if your knee is trying to go into a bowed position (as it might if you’re changing direction quickly on a ski slope, a netball court or a football or rugby pitch), it’s these ligaments that tighten and prevent the knee overextending.
Injuries to the PLC are common in sport, and often occur in conjunction with damage to the posterior cruciate ligament. So if you’ve injured that ligament, your knee specialist will typically want to consider the potential that you’ve also damaged the corner.
Yorkshire Knee Clinic knee surgeons advocate anatomic reconstruction of the posterolateral corner, but it’s important to know that your knee surgeon has a thorough understanding of the anatomy of the knee, because that understanding is crucial to treating PLC injuries effectively.
As Dr LaPrade puts it, “If you understand the anatomy, you can make the surgery slick.”
If you have injured your knee, talk to a Yorkshire Knee Clinic consultant.