الفهرس 
Introduction and aim of workOnly 14 pages are availabe for public view
 |  | from | 194 |  |  |
| | | from | 194 | | |
Abstract
In the past, injuries to the posterolateral corner of the knee were commonly missed. Recent research has helped improve our awareness of this complicated area at the outside back edge of the knee. Although Posterolateral corner (PLC) injuries are not common in sport, a failure to spot one can have devastating, even career-ending consequences for the affected athlete.Becoming familiar with the anatomy and biomechanics of this region can improve one’s ability to detect subtle abnormalities and can perhaps lead to improvements in diagnosing and understanding injuries to this area.Posterolateral knee injuries may present as isolated injuries, an associated injuries with the ACL or PCL or part of the multiple-ligament knee injuries which may be associated with neurovascular injury. The integrity of PLC is determined by clinical tests specially ( varus stress test, posterolateral drawer test, tibial external-rotation test, reversed pivot-shift test)and our evaluation used IKDC system.Posterolateral and associated injuries can be addressed using radiography, MRI and arthroscopy and its components include disruption of popliteus tendon; arcuate ligament complex; LCL and lateral capsular ligament.Forty-one patients included in this study with a primary diagnosis of grade III posterolateral knee instability, fourteen were acute combined injuries(41.1%) five underwent repair(12.1%) and nine underwent ORIF(21.9%), twenty-seven were chronic combined injuries(65.8%). Twelve of the chronic cases underwent reconstruction using biceps tenodesis (29.2%). Fifteen underwent Larson’s reconstruction (36.5%).Twelve underwent high tibial osteotomy in addition to reconstruction procedures (29.2%) All patients evaluated preoperatively and regularly postoperatively for 24-43months. The failure rate was 40% for repair group, 11% for fixation group, 25%for biceps femoris tenodesis group and 6.6% for Larson’s group. The final overall rating Postoperatively 17 patients (41.4%) were rated normal, 17 patients (41.4%) were rated nearly normal, four patients (9.7%) were rated abnormal and three patients (7.3%) were rated severely abnormal. The results in our series of patients clearly favored reconstruction of the PLC with Larson s technique in chronic cases and ORIF for acute cases. Complications include residual varus laxity, vascular injury and failed repair with the need for revisions.Finally, we can conclude that injuries to the lateral structures of the knee including the posterolateral corner are less frequent, but can often lead to chronic instability if missed or inappropriately managed. Also, it can lead to increased stress on associated cruciate reconstructions and premature failure. Despite the recent advances in understanding of the PLC of the knee, there is still no consensus about the surgical technique is better for treatment. Early recognition and treatment of the posterolateral corner provides more reliable results.