Abstract
Evaluation of the overall stability of the anterior cruciate ligament (ACL)-deficient knee can be difficult because of the multitude of additional anatomical structures that can be injured. With the improvement of overall knowledge of the knee-stabilizing structures, it is clear that many lesions are not isolated and occur within a potentially complex context of instability. Consequently, the concept of multiligament injury has evolved in recent years due to many anatomical and biomechanical studies which enhance the understanding of injury mechanisms and validate reconstruction techniques. Among those complex ligamentous injuries, the most common association is ACL and posterolateral corner (PLC).
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Chahla J, Moatshe G, Dean CS, LaPrade RF. Posterolateral corner of the knee: current concepts. Arch Bone Joint Surg. 2016;4(2):97–103.
Kennedy NI, LaPrade CM, LaPrade RF. Surgical management and treatment of the anterior cruciate ligament/posterolateral corner injured knee. Clin Sports Med. 2017;36(1):105–17.
Harner CD, Vogrin TM, Höher J, Ma CB, Woo SL. Biomechanical analysis of a posterior cruciate ligament reconstruction. Deficiency of the posterolateral structures as a cause of graft failure. Am J Sports Med. 2000;28(1):32–9.
LaPrade RF, Resig S, Wentorf F, Lewis JL. The effects of grade III posterolateral knee complex injuries on anterior cruciate ligament graft force. A biomechanical analysis. Am J Sports Med. 1999;27(4):469–75.
LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G. The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med. 2000;28(2):191–9.
Geeslin AG, LaPrade RF. Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. Am J Sports Med. 2010;38(12):2502–8.
LaPrade RF, Wentorf FA, Fritts H, Gundry C, Hightower CD. A prospective magnetic resonance imaging study of the incidence of posterolateral and multiple ligament injuries in acute knee injuries presenting with a hemarthrosis. Arthroscopy. 2007;23(12):1341–7.
Temponi EF, de Carvalho Júnior LH, Saithna A, Thaunat M, Sonnery-Cottet B. Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture. Skelet Radiol. 2017;46(8):1063–70.
LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003;31(6):854–60.
LaPrade RF. Anatomic reconstruction of the posterolateral aspect of the knee. J Knee Surg. 2005;18(2):167–71.
Sanchez AR, Sugalski MT, LaPrade RF. Anatomy and biomechanics of the lateral side of the knee. Sports Med Arthrosc Rev. 2006;14(1):2–11.
Sugita T, Amis AA. Anatomic and biomechanical study of the lateral collateral and popliteofibular ligaments. Am J Sports Med. 2001;29(4):466–72.
Amis AA, Bull AMJ, Gupte CM, Hijazi I, Race A, Robinson JR. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2003;11(5):271–81.
Terry GC, LaPrade RF. The posterolateral aspect of the knee. Anatomy and surgical approach. Am J Sports Med. 1996;24(6):732–9.
Seebacher JR, Inglis AE, Marshall JL, Warren RF. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am. 1982;64(4):536–41.
Kawashima T, Takeishi H, Yoshitomi S, Ito M, Sasaki H. Anatomical study of the fabella, fabellar complex and its clinical implications. Surg Radiol Anat. 2007;29(8):611–6.
Fanelli GC, Orcutt DR, Edson CJ. The multiple-ligament injured knee: evaluation, treatment, and results. Arthroscopy. 2005;21(4):471–86.
Baker CL, Norwood LA, Hughston JC. Acute posterolateral rotatory instability of the knee. J Bone Joint Surg Am. 1983;65(5):614–8.
LaPrade RF, Terry GC. Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med. 1997;25(4):433–8.
Noyes FR, Barber-Westin SD, Hewett TE. High tibial osteotomy and ligament reconstruction for varus angulated anterior cruciate ligament-deficient knees. Am J Sports Med. 2000;28(3):282–96.
Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am. 1976;58(2):173–9.
Laprade RF, Heikes C, Bakker AJ, Jakobsen RB. The reproducibility and repeatability of varus stress radiographs in the assessment of isolated fibular collateral ligament and grade-III posterolateral knee injuries: an in vitro biomechanical study. J Bone Joint Surg Am. 2008;90(10):2069–76.
Jackman T, LaPrade RF, Pontinen T, Lender PA. Intraobserver and interobserver reliability of the kneeling technique of stress radiography for the evaluation of posterior knee laxity. Am J Sports Med. 2008;36(8):1571–6.
McDonough EB, Wojtys EM. Multiligamentous injuries of the knee and associated vascular injuries. Am J Sports Med. 2009;37(1):156–9.
Sanders TL, Johnson NR, Levy NM, et al. Effect of vascular injury on functional outcome in knees with multi-ligament injury: a matched-cohort analysis. J Bone Joint Surg Am. 2017;99(18):1565–71.
Fanelli GC, Stannard JP, Stuart MJ, et al. Management of complex knee ligament injuries. Instr Course Lect. 2010;92(12):2235.
Kannus P. Nonoperative treatment of grade II and III sprains of the lateral ligament compartment of the knee. Am J Sports Med. 1989;17(1):83–8.
Krukhaug Y, Mølster A, Rodt A, Strand T. Lateral ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc. 1998;6(1):21–5.
Arthur A, LaPrade RF, Agel J. Proximal tibial opening wedge osteotomy as the initial treatment for chronic posterolateral corner deficiency in the varus knee: a prospective clinical study. Am J Sports Med. 2007;35(11):1844–50.
Clancy JW, Sutherland TB. Combined posterior cruciate ligament injuries. Clin Sports Med. 1994;13(3):629–47.
Geeslin AG, LaPrade RF. Outcomes of treatment of acute grade-III isolated and combined posterolateral knee injuries: a prospective case series and surgical technique. J Bone Joint Surg Am. 2011;93(18):1672–83.
Levy BA, Stuart MJ. Treatment of PCL, ACL, and lateral-side knee injuries: acute and chronic. J Knee Surg. 2012;25(4):295–305. https://doi.org/10.1055/s-0032-1324813.
Levy BA, Dajani KA, Morgan JA, Shah JP, Dahm DL, Stuart MJ. Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med. 2010;38(4):804–9.
Geeslin AG, Moulton SG, LaPrade RF. A systematic review of the outcomes of posterolateral corner knee injuries, Part 1: Surgical treatment of acute injuries. Am J Sports Med. 2016;44(5):1336–42.
LaPrade RF, Johansen S, Agel J, Risberg MA, Moksnes H, Engebretsen L. Outcomes of an anatomic posterolateral knee reconstruction. J Bone Joint Surg Am. 2010;92(1):16–22.
McCarthy M, Camarda L, Wijdicks CA, Johansen S, Engebretsen L, Laprade RF. Anatomic posterolateral knee reconstructions require a popliteofibular ligament reconstruction through a tibial tunnel. Am J Sports Med. 2010;38(8):1674–81.
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Neri, T., Parker, D. (2019). Management of Combined Anterior Cruciate Ligament and Posterolateral Corner Injury of the Knee. In: Margheritini, F., Espregueira-Mendes, J., Gobbi, A. (eds) Complex Knee Ligament Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58245-9_10
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DOI: https://doi.org/10.1007/978-3-662-58245-9_10
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