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posterolateral corner pain of knee

Humberto G Rosas
Although rare, posterolateral corner (PLC) injuries can result in sustained instability and failed cruciate ligament reconstruction if they are not diagnosed. The anatomy of the PLC was once thought to be perplexing and esoteric-in part because of the varying nomenclature applied to this region in the literature, which added unnecessary complexity. More recently, three major structures have been described as the primary stabilizers of the PLC on the basis of biomechanical study findings: the lateral collateral ligament, popliteus tendon, and popliteofibular ligament...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
M Alex Haddad, Justin M Budich, Brian J Eckenrode
STUDY DESIGN: Case report. BACKGROUND: Isolated, grade III lateral collateral ligament knee injuries are an uncommon traumatic injury with little guidance available in the literature for conservative management and prognosis for return to sport. The purpose of this case report is to describe the clinical decision-making in both differential diagnosis and physical therapy management of an isolated grade III lateral collateral ligament sprain in an adolescent multi-sport high school athlete...
August 2016: International Journal of Sports Physical Therapy
Warwick Chan, Helen Emily Chase, John G Cahir, Neil Patrick Walton
A 37-year-old man presented to the acute knee and sports medicine clinic with atraumatic lateral knee pain. He had point tenderness over the lateral aspect of his knee which had not settled with anti-inflammatory medications. Imaging revealed a large opaque lesion lateral to the knee and although there was no clear mechanism, injury to the posterolateral corner was considered. An MRI subsequently revealed a rare case of calcific tendinitis to the biceps femoris tendon insertion. This condition was self-limiting and did not require interventions such as steroid injections...
2016: BMJ Case Reports
Friedrich Boettner, Lisa Renner, Danik Arana Narbarte, Claus Egidy, Martin Faschingbauer
PURPOSE: The study reports the 2-year follow-up results of patients with valgus osteoarthritis undergoing total knee arthroplasty (TKA) with a standardized soft-tissue release. METHODS: Between 2008 and 2013, 222 TKAs were performed for valgus osteoarthritis by a single surgeon. A total of 181 TKAs in 164 patients were available for a minimum 2-year follow-up (range 24-87 months). Preoperative and postoperative range of motion (ROM), mechanical alignment, the postoperative medial proximal tibial angle (MPTA), Western Ontario and McMaster Universities Arthritis Index (WOMAC), VF-12 score, visual analogue pain scale (VAS), and the actual UCLA activity score, desired UCLA score, ligamentous stability (medial collateral ligament) and complications and revision rates were recorded...
August 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Hwan Seong Cho, Yeong Kyoon Park, Joo Han Oh, Jung Hyun Lee, Ilkyu Han, Han-Soo Kim
Chondroblastoma has a predilection for the epiphyses or apophyses of long tubular bones. Management of lesions in the proximal tibia is challenging because it is difficult to gain access to intraepiphyseal lesions for completion of curettage. From October 2007 to December 2011, 9 patients with de novo chondroblastoma of the proximal tibia underwent surgery at the authors' institution. All patients initially presented with pain, and 5 patients had limitation of range of motion of the ipsilateral knee. Four lesions abutted the tibial attachment sites of the cruciate ligaments...
January 2016: Orthopedics
Taoufik Cherrad, Jamal Louaste, Hicham Bousbaä, Larbi Amhajji, Rachid Khaled
The fabella is a sesamoid bone that may contribute to the stabilization of the posterolateral knee corner and it can very occasionally act as a source of atypical and rare knee pain and functional impairment. Fracture of the fabella is a rare but important clinical entity which may be overlooked clinically and radiographically. However, it causes an intermittent mechanical pain of the knee and it can mistakenly harm another knee pathology like intra-articular loose body. We report a case of a 21-year-old man who was sustaining a fracture of fabella following vehicle accident...
2015: Case Reports in Orthopedics
Erica Bulgheroni, Paolo Bulgheroni
A 33-year-old Caucasian woman came to our attention complaining of lateral knee pain on the left side, severe external instability associated with varus malalignment, and difficulties in weight-bearing activities. The symptoms had appeared following two lateral meniscectomies on her discoid meniscus, performed elsewhere. The patient was initially submitted to an allograft meniscus transplantation exploiting the unloaded condition of lateral compartment and obtained pain relief. The posterolateral corner was reconstructed in combination with a valgus osteotomy to address the posterolateral rotatory instability...
April 2014: Joints
A Wajsfisz, X Bajard, S Plaweski, P Djian, G Demey, R Limozin, V Bousquet, G Rocheconcar, M-L Louis, J Arndt, M Azar, B Sonnery-Cottet, P Boisrenoult
INTRODUCTION: Management of combined anterior or posterior cruciate ligament and posterolateral corner tears is still poorly codified. The aim of this study was to evaluate functional outcome after complete surgical treatment. MATERIALS AND METHODS: This retrospective multicenter study included 53 patients. Mean age was 29.8 yrs. (15-49). The anterior and posterior cruciate ligaments were involved in respectively 48 and 5 cases. Mean time to surgery was 25.6 months (0-184), and in 10 cases less than 21 days...
December 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
Camilo Partezani Helito, Marcelo Batista Bonadio, Marco Kawamura Demange, Roberto Freire da Mota e Albuquerque, José Ricardo Pécora, Gilberto Luis Camanho, Fabio Janson Angelini
PURPOSE: A technique for combined reconstruction of the anterior cruciate ligament (ACL) and posterolateral corner (PLC) with a single femoral tunnel was recently described. This technique aims to avoid tunnel confluence in the lateral femoral condyle. Because there have been no studies on the functional outcomes and possible complications of this technique, our goal is to demonstrate a two-year minimum follow-up of patients who underwent this type of reconstruction. METHODS: Nine patients were prospectively evaluated...
March 2015: International Orthopaedics
W A van der Wal, P J C Heesterbeek, T G van Tienen, V J Busch, J H M van Ochten, A B Wymenga
PURPOSE: The goal of this study was to present a 2- to 5-year prospective follow-up of an anatomical posterolateral corner reconstruction in a series of 16 patients with symptomatic instability and pain complaints of the knee. METHODS: All 16 patients underwent a posterolateral corner reconstruction as described by LaPrade et al. If cruciate ligament ruptures were present and had not been addressed earlier, these were reconstructed as well. Preoperatively and 2-5 years after surgery, multiple subjective knee outcome scores (VAS satisfaction score, Tegner, Lysholm, Noyes score and IKDC subjective knee form) were obtained, and the laxity of the joint was evaluated objectively by using bilateral varus stress radiographs to compare the injured with the uninjured knee...
January 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tom Adler, Niklaus F Friederich, Felix Amsler, Werner Müller, Michael T Hirschmann
PURPOSE: The purpose of this study was to analyse the long-term outcome of patients treated for combined posterior cruciate ligament (PCL) and posterolateral corner injuries by combined PCL reconstruction and popliteus bypass according to Mueller or refixation of the popliteus tendon. METHODS: Sixteen patients treated by combined PCL reconstruction and popliteus bypass according to Mueller (n = 7) or refixation of the popliteus tendon (n = 9) were included...
January 2015: International Orthopaedics
Matthew Cartwright-Terry, Jonny Yates, Chin K Tan, Ioannis P Pengas, Joanne V Banks, Michael J McNicholas
PURPOSE: To present a 5-year comparison of the functional outcomes of combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction with those of isolated ACL reconstruction. METHODS: All patients were reviewed clinically and completed knee function questionnaires prospectively, by use of the International Knee Documentation Committee (IKDC) 2000, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scoring systems, preoperatively and at 1, 2, and 5 years postoperatively...
July 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Itai Gans, Martin J Morrison, Kudakwashe R Chikwava, Lawrence Wells
The differential diagnosis for an intra-articular lesion in the knee of a pediatric patient is broad. Diagnostic considerations include pigmented villonodular synovitis (PVNS)-the most common intra-articular tumor-and a variety of both benign and malignant tumors, including lipomas, hemangiopericytomas, nodular fasciitis, parosteal osteosarcomas, and fibromyxoid sarcomas. If there is concern over possible malignant lesions, a tumor surgeon should be consulted. Precise pathologic diagnosis is ideal for identifying these enigmatic lesions and for determining the appropriate treatment plan...
March 2014: Orthopedics
Camilo Partezani Helito, Marcelo Batista Bonadio, Marco Kawamura Demange, Roberto Freire da Mota e Albuquerque, José Ricardo Pécora, Gilberto Luis Camanho, Fábio Janson Angelini
BACKGROUND: Many reconstruction techniques have already been developed for treating posterolateral corner (PLC) injuries, with still no consensus regarding what would be the best option. Some techniques use non-bone tunnel fixation, attaching the graft to the femur using a cortical screw with toothed washer. The main objective of the present study is to evaluate complications related to fixation performed by a screw and toothed washer technique. METHODS: A prospective study with surgical reconstruction of the PLC structures of the knee between January 2008 and December 2009 was performed...
June 2014: Knee
Michael Jabara, Jeffrey Bradley, Michael Merrick
BACKGROUND: The incidence of proximal tibiofibular joint instability in the setting of the multiligament-injured knee has not been previously reported. The integrity of the proximal tibiofibular joint is required to perform a fibular-based, lateral-sided knee reconstruction. QUESTIONS/PURPOSES: We report (1) the frequency of proximal tibiofibular joint instability in patients presenting with multiligament knee injuries and evaluate (2) our ability to restore stability to this joint, (3) patient-reported outcome scores, and (4) complications in patients surgically treated for proximal tibiofibular joint instability at the time of treatment of multiligament knee instability...
September 2014: Clinical Orthopaedics and related Research
Siddharth P Jadhav, Snehal R More, Roy F Riascos, Diego F Lemos, Leonard E Swischuk
The popliteus is a relatively small but unique muscle of the knee. It is a component of the posterolateral corner of the knee and acts as a major stabilizer of the posterolateral knee. It is important to be aware of the normal magnetic resonance (MR) imaging appearance of the popliteus musculotendinous complex and its relation to other structures of the posterolateral corner for accurate diagnosis. It is also important to be aware of the pitfalls in imaging of the popliteus. Dysfunction of the popliteus is often underappreciated and is usually secondary to direct or indirect trauma...
March 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Daniel J Del Gaizo, Craig J Della Valle
Instability is one of the most common causes of failure of total knee arthroplasty (TKA). The presentation can vary from pain to frank dislocation with the etiologies just as varied. Instability after TKA can be classified by where the instability occurs in the knee's arc of motion as well as the chronicity of the problem. Acute instability is related to intraoperative injuries or excessive release of important coronal stabilizers such as the medial collateral ligament in extension or the posterolateral corner in flexion...
September 2011: Orthopedics
A J Yenchak, Kevin E Wilk, Christopher A Arrigo, Charles D Simpson, James R Andrews
STUDY DESIGN: Case report. BACKGROUND: Joint stiffness, also called arthrofibrosis, remains the primary complication following any reconstructive knee surgery. Acute anterior cruciate ligament surgery, performed with concomitant multiple ligamentous repair and/or reconstruction, further increases the likelihood of developing impaired knee motion following surgery. The purpose of this case report is to present a criteria-based approach to the postoperative management of a multiligament knee injury...
September 2011: Journal of Orthopaedic and Sports Physical Therapy
Jong-Won Chung, Soon-Hyuck Lee, Seung-Beom Han, Hyun-Jung Hwang, Dae-Hee Lee
A woman presented with knee pain and locking. Pain was exacerbated at the end of the range of motion, especially during extension, with locking symptoms similar to those associated with a meniscus bucket handle tear. Ligamentous laxity was not definite. Plain radiographs showed multiple calcified loose bodies. Magnetic resonance imaging (MRI) showed a lobulated mass that was hypointense to muscle on T1-weighted sequences and hyperintense to muscle on T2-weighted sequences in the anterior cruciate ligament (ACL)...
February 2011: Orthopedics
Benigno Zenteno Chávez, Ibis Fernando Morales Chaparro, Iliana G De la Torre
OBJECTIVE: To present a case of fabella syndrome in a 27-year-old high performance runner who responded favorably to the surgical resection of this sesamoid bone, after multiple failed conservative treatments. To discuss the difficulty to diagnose this syndrome due to its anatomical location, and mention the frequent performance of unnecessary arthroscopic studies and procedures in this type of patients. We present the case of a high performance runner who underwent multiple tests and treatments for left posterolateral knee pain, which was resolved surgically; the specimen was sent to pathology for the confirmation of the diagnosis...
July 2010: Acta Ortopédica Mexicana
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