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. 2023 Apr 11:8:13.
doi: 10.21037/aoj-22-28. eCollection 2023.

Patient demographic and magnetic resonance imaging evaluation of isolated posterolateral corner knee injuries

Joao Pedro de Guimaraes Fernandes Costa  1 , Jair Antunes Eleterio Neto  2 , Marcelo Bordalo Rodrigues  3 , Camilo Partezani Helito  4   5 , Paulo Victor Partezani Helito  1   6
Affiliations

Patient demographic and magnetic resonance imaging evaluation of isolated posterolateral corner knee injuries

Joao Pedro de Guimaraes Fernandes Costa et al. Ann Jt. .

Abstract

Background: Posterolateral stability of the knee is maintained by capsular, ligamentous and tendinous structures, which collectively are known as the posterolateral corner (PLC). Injuries to the PLC of the knee rarely occur without associated anterior (ACL) or posterior cruciate (PCL) ligament tears. The main objectives of our study were to report patient demographics and magnetic resonance imaging (MRI) findings of patients with isolated PLC injuries.

Methods: This study consists of a retrospective analysis of knee MRI from January 2011 to June 2016, in two hospitals in São Paulo, Brazil, where PLC injuries without associated ACL and PCL injuries were identified in MRI by two radiologists specialized in musculoskeletal injuries. Relative and absolute frequencies were used to describe the injuries of each of the PLC structures in the study cases.

Results: A total of 23 cases of PLC injuries without associated cruciate ligament injuries were identified. The mean age of patients was 32.0±8.1 years and 91% patients were male. The main sport associated with isolated PLC injury was Brazilian Jiu-Jitsu (48%), followed by soccer (35%). MRI evaluations of the knees showed lateral collateral ligament (LCL) injuries in 70% of cases, popliteus tendon injuries in 26% of cases and distal biceps tendon injuries in 30% of cases. The popliteofibular ligament (PFL) was damaged in 83% of cases. An associated ALL injury was observed in 43% of cases.

Conclusions: Isolated PLC injuries occurred mainly in young men when practicing Brazilian Jiu-Jitsu and soccer. The LCL was the most frequently injured larger structure in association, and the capsuloligamentous structures (PFL) were the most frequently injured structures overall. ALL injuries occurred in approximately half of the cases, most often concomitantly with LCL injuries.

Keywords: Isolated posterolateral corner; soccer; trauma.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.com/article/view/10.21037/aoj-22-28/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A 25-year-old man with a knee injury sustained while playing soccer. Magnetic resonance images in the coronal (A,C) and axial (B) planes with T2 weighted sequences with fat saturation. The images show high-grade injuries in the distal third of the lateral collateral ligament (white arrow) and in the distal biceps femoris tendon insertion (white arrowhead) and a capsuloligamentous injury of the posterolateral corner with popliteofibular ligament rupture (black arrow).
Figure 2
Figure 2
A 33-year-old man with a knee injury sustained while playing soccer. Magnetic resonance image in the axial plane (A), sagittal plane (B) and coronal plane (C) with T2 weighted sequences with fat saturation. The images show an injury at the myotendinous junction of the popliteus muscle (arrows).
Figure 3
Figure 3
A 38-year-old man with a knee injury sustained while practicing Jiu-Jitsu. Magnetic resonance images in the coronal (A, B and C) plane with T2 weighted sequences with fat saturation. The images show high-grade injuries at the lateral collateral ligament origin (white arrows) and in the femoral portion of the anterolateral ligament (black arrow).
See this image and copyright information in PMC

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