Posterolateral Corner Injury

PLC injuries often occur due to high-impact trauma, such as sports injuries, car accidents, or falls. The most common cause is a blow to the inner knee while the foot is planted, forcing the knee to bend outwards. They can also occur with hyperextension (forced straightening) of the knee or severe twisting injuries. Though they can sometimes happen in isolation, they usually occur with injuries to other ligaments such as the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL).

Symptoms of a PLC injury may include:

• Pain and swelling on the outside and back of the knee
• Difficulty walking, particularly on uneven surfaces
• Feeling of instability in the knee, like it’s going to give way
• Difficulty straightening the knee fully

While minor PLC injuries can sometimes heal with conservative treatment, significant injuries often require surgical intervention. Without proper treatment, a PLC injury can lead to chronic knee instability and early-onset arthritis.

A PLC injury is diagnosed through a combination of physical examinations, patient history, and imaging tests like X-rays and MRIs. Special tests like the dial test, varus stress test, and reverse pivot shift test can help evaluate knee stability and identify a PLC injury.

Initial treatment often involves rest, ice, compression, and elevation (RICE). Physical therapy may be used to regain knee function and strength. However, if the knee remains unstable or the injury is severe, surgical reconstruction may be required.

Surgery is often recommended for patients with persistent instability, significant injuries, or if the injury is combined with other ligament injuries. The timing of surgery varies depending on the severity of the injury and the patient’s overall health.

During a PLC reconstruction, the goal is to restore the anatomy and function of the damaged structures. This involves making a large incision on the outside of the knee, then using grafts (usually from a tissue bank) to reconstruct the damaged ligaments.

Recovery after PLC reconstruction involves a period of immobilization, followed by a graduated physical therapy program. Patients typically begin range-of-motion exercises a few weeks after surgery. Full recovery and return to normal activities can take 6-12 months.