[Imaging of posterolateral rotational instability of the knee joint]
- PMID: 38289375
- DOI: 10.1007/s00117-023-01258-w
[Imaging of posterolateral rotational instability of the knee joint]
Abstract
Posterolateral instability of the knee joint typically occurs with injuries to the posterolateral corner of the joint or with additional combined injuries involving the anterior and posterior cruciate ligaments. In addition to numerous, smaller anatomical structures, the most important are the lateral collateral ligament (LCL), the popliteus muscle with its tendon, and the popliteofibular ligament (PFL), which can usually be assessed using magnetic resonance imaging (MRI). On the contrary, small structures like the arcuate ligament and fabellofibular ligament cannot always be identified. However, they are also of lesser importance in the development of posterolateral rotational instability. Overlooked injuries to the posterolateral joint corner promote instability with the complication of inadequate ligament reconstruction and early onset posttraumatic osteoarthritis. Knowledge of MRI morphology of the anatomical structures involved, taking into account their biomechanical significance, is crucial to recognize and use the corresponding imaging findings.
Die posterolaterale Instabilität des Kniegelenks tritt typischerweise bei Verletzungen der posterolateralen Gelenkecke oder bei zusätzlichen Kombinationsverletzungen mit Beteiligung des vorderen und hinteren Kreuzbands auf. Neben zahlreichen, kleineren anatomischen Strukturen sind an erster Stelle das laterale Kollateralband (LCL), der M. popliteus mit dessen Sehne sowie das popliteofibulare Band (PFL) zu nennen, welche bildgebend mittels Magnetresonanztomographie (MRT) in der Regel gut zu beurteilen sind. Kleinere Strukturen wie das Lig. arcuatum und das Lig. fabellofibulare sind nicht regelhaft abzugrenzen, und sind von geringerer Bedeutung für die Entwicklung einer posterolateralen Rotationsinstabilität. Übersehene Verletzungen der posterolateralen Gelenkecke begünstigen jene Instabilität mit der Komplikation von insuffizienten Bandrekonstruktionen und dem frühen Auftreten einer posttraumatischen Arthrose. Die Kenntnis der MRT-Morphologie der beteiligten anatomischen Strukturen unter Berücksichtigung der biomechanischen Bedeutung ist entscheidend, um die entsprechenden bildgebenden Befunde zu erkennen und zu benennen.
Keywords: Popliteus tendon complex; Posterolateral corner injuries; Posttraumatic osteoarthritis; Tibial external rotation; Varus instability.
© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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