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posterolateral corner

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
Jorge Chahla, Chase S Dean, Justin J Mitchell, Gilbert Moatshe, Raphael Serra Cruz, Robert F LaPrade
Genu varus malalignment can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis. To slow this process, a medial opening wedge proximal tibial osteotomy (PTO) can be performed. This type of PTO is indicated in patients with genu varus malalignment and isolated medial compartment osteoarthritis of the knee, prior to or concurrent with medial compartment cartilage procedures or meniscal transplants, chronic posterolateral corner deficiency, or chronic anterior cruciate ligament deficiency...
August 2016: Arthroscopy Techniques
Eisuke Nomura, Hisatada Hiraoka, Hiroya Sakai
We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery...
2016: Case Reports in Orthopedics
Jordi Tomás-Hernández, Joan Minguell Monyart, Jordi Teixidor Serra, Merce Reverté Vinaixa, Ernesto Guerra Farfan, Vicente Molero García, Enric Castellet Feliu
Tibial plateau fractures are a heterogeneous group of lesions with multiple fracture patterns. They are often associated with soft tissue injuries, the lateral meniscus and the anterior cruciate ligament (ACL) being the most common structures affected. The purpose of this article is to present a case series of an often missed unusual injury pattern that consists on the association of a large anteromedial tibial plateau fracture with a posterolateral (PL) knee corner injury without involvement of the cruciate ligaments...
September 2016: Injury
Vincenzo Giordano, Joseph Schatzker, Mauricio Kfuri
High-energy fractures of the proximal tibia with extensive fragmentation of the posterior rim of the tibial plateau are challenging. This technique aims to describe a method on how to embrace the posterior rim of the tibial plateau by placing a horizontal precontoured one-third tubular plate wrapped around its corners. This method, which we named "hoop plating," is mainly indicated for cases of crushed juxta-articular rim fractures, aiming to restore cortical containment of the tibial plateau. Through a lateral approach with a fibular head osteotomy (Lobenhoffer approach), both anterolateral and posterolateral fragments are directly reduced and supported by a one-third tubular plate of adequate length...
September 29, 2016: Journal of Knee Surgery
Clemens Gwinner, Andreas Weiler, Manoussos Roider, Frederik M Schaefer, Tobias M Jung
BACKGROUND: The reported failure rate after posterior cruciate ligament (PCL) reconstruction remains high. Previous studies have shown that the tibial slope (TS) influences sagittal plane laxity. Consequently, alterations of TS might have an effect on postoperative knee stability after PCL reconstruction. HYPOTHESIS: We hypothesized that flattening of TS is associated with increased posterior laxity after PCL reconstruction. STUDY DESIGN: Cohort study; Level of evidence 3...
September 20, 2016: American Journal of Sports Medicine
Ali M Naraghi, Lawrence M White
Acute knee injuries are a common source of morbidity in athletes and if overlooked may result in chronic functional impairment. Magnetic resonance (MR) imaging of the knee has become the most commonly performed musculoskeletal MR examination and is an indispensable tool in the appropriate management of the injured athlete. Meniscal and ligamentous tearing are the most frequent indications for surgical intervention in sports injuries and an understanding of the anatomy, biomechanics, mechanisms of injury, and patterns of injury are all critical to accurate diagnosis and appropriate management...
October 2016: Radiology
Hirotaka Takahashi, Goro Tajima, Shuhei Kikuchi, Jun Yan, Yoichi Kamei, Moritaka Maruyama, Atsushi Sugawara, Takaaki Saigo, Minoru Doita
PURPOSE: To clarify the fibular head insertion of the fibular collateral ligament (FCL), popliteofibular ligament (PFL), and biceps femoris tendon and related osseous landmarks on three-dimensional (3-D) images. METHODS: Twenty-one non-paired, formalin-fixed human cadaveric knees were evaluated in this study. The fibular head insertions of the FCL, PFL and biceps femoris tendon were identified and marked. 3-D images were created, and the surface area, location, positional relationships, and morphology of the fibular insertions of the FCL, PFL, and biceps femoris tendon and related osseous structures were analysed...
September 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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
Volker Musahl, Ata A Rahnemai-Azar, Joanna Costello, Justin W Arner, Freddie H Fu, Yuichi Hoshino, Nicola Lopomo, Kristian Samuelsson, James J Irrgang
BACKGROUND: The role of the anterolateral capsule (ALC) as a secondary restraint to quantitative rotatory laxity of patients with an anterior cruciate ligament (ACL) injury is currently debated. PURPOSE/HYPOTHESIS: The purpose was to determine the influence of concomitant ALC injuries as well as injuries to other soft tissue structures on rotatory knee laxity in patients with an ACL injury. It was hypothesized that a concomitant ALC injury would be associated with increased rotatory knee laxity as measured during a quantitative pivot-shift test...
August 9, 2016: American Journal of Sports Medicine
Zhen Lai, Zhi-xiang Liu, Jun-long Yang, Zhao-fei Zhang, Yi-liang Chang
OBJECTIVE: To evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints. METHODS: From March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31...
May 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
T H Lui, L K Chan
BACKGROUND: The list of indications of posterior ankle endoscopy is expanding and includes various soft tissue and bony pathologies of the posterior ankle. Some of the indications, e.g. release of frozen ankle, debridement of posteromedial soft tissue impingement of the ankle and debridement or fixation of the posteromedial osteochondral lesion of the talus, require approach to the posterior ankle medial to the flexor hallucis longus tendon. The purpose of this study was to assess the risk of injury to the posterior tibial neurovascular bundle during posterior ankle endoscopy...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ravi Gupta, Tanu Khanna, Gladson David Masih, Anubhav Malhotra, Anil Kapoor, Pawan Kumar
BACKGROUND: Anterior cruciate ligament (ACL) tear rates are known to vary from sport to sport. To the best of our knowledge, the relationship of ACL injury with different sports is not reported earlier. The objective of the present study is to investigate the association of ACL injury with different sports and to document various associated ligamentous, meniscal, and chondral lesions of the knee. MATERIALS AND METHODS: Descriptive epidemiological study was carried out in a tertiary care center over a 10-year period...
July 2016: Journal of Clinical Orthopaedics and Trauma
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
Gilbert Moatshe, Erik L Slette, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations are rare but potentially devastating injuries, often involving tears of multiple knee ligaments. Several studies have reported improved clinical and functional outcomes with surgical management of torn knee ligaments compared with nonsurgical management. Most multiple ligament reconstruction techniques involve creating several tunnels for various reconstruction grafts, posing a risk of tunnel convergence in the proximal tibia. PURPOSE: To assess the risk of tunnel convergence and determine the optimal tunnel placement for the reconstruction of multiple ligaments in the tibia...
July 28, 2016: American Journal of Sports Medicine
Patrick A Meere, Svenja M Schneider, Peter S Walker
BACKGROUND: Balancing is an important part of a total knee procedure, and in recent years, more emphasis has been given to quantifying the process. METHODS: During 101 total knee surgeries, initial bone cuts were made using navigation. Lateral and medial contact forces were determined throughout flexion using an instrumented tibial trial. Balancing was defined as a ratio of the medial and total force, the target being 0.5 (equal lateral and medial forces). Based on the initial values, surgical corrections were selected to achieve balancing...
September 2016: Journal of Arthroplasty
J Pogorzelski, S Braun, A B Imhoff, K Beitzel
OBJECTIVE: Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. INDICATIONS: Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. CONTRAINDICATIONS: General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance...
June 29, 2016: Operative Orthopädie und Traumatologie
Gilbert Moatshe, Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Robert F LaPrade
Fibular collateral ligament (FCL) injuries can lead to varus instability of the knee, causing a varus thrust gait and resulting in increased forces on the medial compartment of the knee. In the long term, this can result in meniscal injuries and medial compartment osteoarthritis. Varus instability is also reported to increase forces on the cruciate ligaments, which can lead to overload and failure of these reconstructions in cases of nonrecognized combined injuries. Historically, both repair and reconstruction have been used for grade III injuries to the FCL...
April 2016: Arthroscopy Techniques
Richard Norris, Michael James McNicholas
No abstract text is available yet for this article.
June 22, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
H Hoekstra, K Kempenaers, S Nijs
OBJECTIVES: Variable angle locking compression plates allow for lateral buttress and support of the posterolateral joint surface of tibial plateau fractures. This gives room for improvement of the surgical 3-column classification approach. Our aim was to revise and validate the 3-column classification approach to better guide the surgical planning of tibial plateau fractures extending into the posterolateral corner. METHODS: In contrast to the 3-column classification approach, in the revised approach the posterior border of the lateral column in the revised approach lies posterior instead of anterior of the fibula...
June 8, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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