The Posterior Lateral Corner
The posterior lateral corner is a region of the knee sometimes referred to as “the dark side of the knee” because it was complex and poorly understood. Due to recent advances in the understanding of the anatomy, and the biomechanics, this anatomic region is now accessible for treatment. The posterior lateral corner is comprised primarily of:
- Fibular Collateral Ligament (FCL sometimes called LCL or lateral collateral ligament)
- Popliteus tendon
- Popliteus muscle
- Poplitealfibular ligament
- Arcuate ligament
- Fabellofibular ligament
- Biceps femoris
- Lateral gastrocnemius muscle
- Iliotibial Band (IT Band)
- Peroneal Nerve
Low grade sprains of any one of the structures of the posterior lateral corner can often be treated with a brace and activity modification for 6 weeks. Bracing and rehab is the key to success for this treatment strategy.
Unfortunately, posterior lateral corner injuries are often associated with other ligament injuries such as ACL or PCL tears. Because of this, surgery is often needed to fix these problems. The posterior lateral corner is reconstructed with donor ligaments through drill holes in the bones specifically placed to reconstruct the normal anatomy. Posterior lateral corner injuries can sometimes be missed and should always be considered in patients who have a failed ACL reconstruction as it is one of the common causes of ACL reconstruction failure and revision.
Recovery and Rehabilitation
Posterior lateral corner injuries will require significant work in therapy. Range of motion will be restricted in the first 2 weeks. For complex injuries, this may be increased to 6 weeks. Patients will be on crutches with no weight on the leg and a brace for 6 weeks. The initial recovery period is focused on swelling, pain control, and range of motion.
- How long does surgery take? 2-4 hours depending upon how many ligaments need reconstruction.
- What kind of anesthesia will I need? General anesthesia is typically used, sometimes with a nerve block for pain control after surgery.
- How long will I be in the hospital? Many patients can leave that same day, occasionally Dr. Petre will have you stay one night in the hospital
- Is surgery safe? All surgery has risks; however, this surgery when compared to all other surgery is very safe.
- Will I need physical therapy? Yes. Physical therapy is crucial to an excellent outcome.
- How long before I can return to work/school? For jobs and academics that require minimal physical exertion and can be done with crutches, many people can return in 2 weeks. For jobs that require heavy lifting or exertion, it is safe to plan 8 weeks off.
- How long before I can return to my sports? Return to sports depends upon what ligaments are being reconstructed and varies between 6 moths to one year.
- How long before i can drive a car? All patients must be off pain medicine before driving. Many patients can return to driving in 2 weeks once they feel completely safe operating a vehicle. Right legged injuries will be slower than left legged injuries.
- How long will I be on crutches? 6 weeks.
- How long will I need pain medicine? Most patients need 3-5 days of pain medicine and sometimes up to 2 weeks. If you are still having pain requiring narcotic pain medicine after a month, Dr. Petre may ask you to see a pain specialist.
- How long will I need a brace? 6 weeks.