Injuries of the Posterolateral Corner of the Knee

The complex anatomy of the posterolateral corner of the knee is due largely to the evolutionary changes in the anatomic relationships of the fibular head, the popliteus tendon, and the biceps femoris muscle. Recent research has improved our understanding of the popliteus complex, particularly the role of the popliteofibular ligament. Biomechanical studies provide a scientific basis for clinical examination of the knee with suspected injury of the posterolateral corner. All grade-I and most moderate grade-II injuries of the posterolateral structures can be treated nonoperatively, but residual laxity may remain, especially in knees with grade-II injury. Acute grade-III isolated or combined injury of the posterolateral corner is best treated early, by direct repair, if possible, or else by augmentation or reconstruction of all injured ligaments. Chronic injury of the posterolateral corner, whether isolated or combined, is probably best treated by reconstruction of the posterolateral corner along with reconstruction of any coexisting cruciate ligament injury. Failure to diagnose and treat an injury of the posterolateral corner in a patient who has a known tear of the anterior or posterior cruciate ligament can result in failure of the reconstructed cruciate ligament.