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Surgical Approach to Posterolateral Chronic Injury

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Knee Ligament Injuries

Abstract

Injuries to the posterolateral corner (PLC) of the knee have gained increased attention over the last two decades. The PLC is described functionally by three major static stabilizers: the fibular collateral ligament (FCL), the popliteus tendon, and the popliteofibular ligament. Injuries to these structures account for up to 16 % of all ligamentous injuries to the knee. When injured, the PLC structures are more often part of combined ligament injuries. Moreover, chronic complete (Grade III) PLC injuries can lead to pain, instability, meniscal tears, osteoarthritis, and failure of anterior and posterior cruciate ligament reconstruction grafts if left untreated. Therefore, proper diagnosis and treatment is essential in order to maximize patient outcomes and expedite return to activity. An anatomic-based surgical reconstruction is favored over repair due to better reported long-term outcomes. However, in spite of recent advances, there remains a paucity of literature on the treatment of PLC injuries in comparison to other ligamentous injuries of the knee. In this chapter, the general principles of the diagnosis and treatment of chronic PLC injuries will be discussed, with a focus on the essentials of preoperative planning, an anatomic-based reconstruction, and postoperative rehabilitation that are required for a successful surgical outcome.

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Authors and Affiliations

  1. Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA

    Evan W. James

  2. Howard Head Sports Medicine, 181 West Meadow Drive, Vail, CO, 81657, USA

    Luke T. O’Brien

  3. The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA

    Robert F. LaPrade

  4. Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine University of Oslo, Bergslia 22, Oslo, 0870, Norway

    Lars Engebretsen

  5. Oslo Sports Trauma Research Center, Norwegian University of Sport Sciences, Oslo, Norway

    Lars Engebretsen

Authors
  1. Evan W. James
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  2. Luke T. O’Brien
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  3. Robert F. LaPrade
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  4. Lars Engebretsen
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Correspondence to Evan W. James .

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Editors and Affiliations

  1. Mauriziano “Umberto I” Hospital, Turin, Italy

    Roberto Rossi

  2. University of Rome “Foro Italico”, Rome, Italy

    Fabrizio Margheritini

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James, E.W., O’Brien, L.T., LaPrade, R.F., Engebretsen, L. (2014). Surgical Approach to Posterolateral Chronic Injury. In: Rossi, R., Margheritini, F. (eds) Knee Ligament Injuries. Springer, Milano. https://doi.org/10.1007/978-88-470-5513-1_9

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  • DOI: https://doi.org/10.1007/978-88-470-5513-1_9

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5512-4

  • Online ISBN: 978-88-470-5513-1

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