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Author Topic: Posterolateral corner injury...do I need surgery  (Read 1827 times)

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Offline charl85

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Posterolateral corner injury...do I need surgery
« on: March 24, 2011, 12:34:33 PM »
Has anyone out there had a posterolateral corner injury?  I need advice

My physio suspects a PLC injury, I have a positive dial test, my tibia is twisted causing the leg to bow outwards and I have hyper extension.

The problem is that she doesn't really know what to do, all the consultants in our area don't do PLC repairs and believe that physio will improve it.  I would love it if physo helped out but 6 months down the line and the bowed leginess is getting worse and i am a long way off returning to sport.

Has anyone had sucessful rehab with physio and bracing?  I play Netball and aged 25 I am not ready to retire just yet!  But I don't want to get 20+ years down the line and not be able to run around with my kids/grandkids because my knee is screwed up!

Anyone had surgery?  Who with?  Was it worth it?

Any advice would be great!!
Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon

Offline Kaputt_Knee

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Re: Posterolateral corner injury...do I need surgery
« Reply #1 on: March 24, 2011, 02:23:27 PM »
I had surgery to repair a missed PLC injury and also a torn off LCL. I went for nearly 3 years with the pain getting worse all the time. So surgery was the best solution for me. I was able to return to skiing after 5.5 months.

You should get a referral to a specialist in these injuries, not just an experienced surgeon. Depending on the injury, you may be able to recover without surgery. Have you done a search on here for PLC treatments? There is an interesting article on them in the Information Hub that may help if you have not yet found it.

Whereabouts are you based?  You talk about netball so I'm assuming, UK, Australia or New Zealand (as it is the middle of the night there probably not NZ  ;D ) It helps people to recommend doctors or hospitals if they know where you are in the world!

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline charl85

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Re: Posterolateral corner injury...do I need surgery
« Reply #2 on: March 24, 2011, 06:49:31 PM »
Hi sue,

Thanks for your reply. I'm in the uk, just outside of london.

Where are you based? My physio seemed pretty certain that surgeons in my nhs area wouldn't do surgery at all and I would have to go further afield. I would rather avoid surgery but really don't want to damage everything else in the knee by carrying on with rehab. My gut instinct is that it is quite badly injured as I have read how hard it is to diagnose and my physio noticed it straight away, the tibia has since got more twisted and stability no better.  I have been doing pt for almost 6 months and thought that it would have improved my now if it was going to!

Thanks for advice on the article in the information hub, I will def read that.  Did you have any success with taping or braces in the three years before you had surgery?

Many thanks, charlotte
Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon

Offline Kaputt_Knee

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Re: Posterolateral corner injury...do I need surgery
« Reply #3 on: March 24, 2011, 07:20:38 PM »
I'm based in southern Germany on the Austrian border - a foot in both camps so to speak as the actual border is only a couple of kilometres away.

No I did not brace or tape.

I did not know I had a PLC injury until my current surgeon did an evaluation as to why I was getting increasing amounts of pain on the outside rear part of my reconstructed knee. He told that there was an injury and operated about 5 weeks later.

When he went in to do the revision of my ACL reconstruction (another tale or woe and problems without end!  ;) ), he said he would also look at the PLC and sort out the problem. What it turned out to be was a fracture of the Fibula head that had been missed originally and a completely avulsed LCL. The fib had heal but incorrectly and the resulting scar tissue was compressing the nerves that run down that way. He reset the fib and replaced the now useless LCL. Had it been seen in the original diagnosis they would have been able to reset it as there was a good bone plug on the free end apparently. C'est la vie.

I'm fine now, although I could be much fitter but being a desk jockey these days I do not get out of the office as much as I would like. I used to be a PE teacher in the UK and enjoyed a high level of sports in my spare time as well. I now really only ski and paraglide with the occasional day's sailing and biking thrown in for good measure.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline charl85

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Re: Posterolateral corner injury...do I need surgery
« Reply #4 on: March 25, 2011, 08:34:50 AM »
Write, you went through a lot! Is also nice to know that your knee cab stand up to quite a lot of sports, that fills me with some confidence!

Did you have surgery in germany? If it was in the uk could you recommend a surgeon?

Netball is such a hard sport on the knees but from what I've read I don't think rehabbing a plc injury will give enough stability to play so will probably be facing surgery if I want to keep playing.

Did you ever get any advice on the effect of having continued for three years without surgery...arthritis etc?

Charlotte
Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon

Offline Kaputt_Knee

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Re: Posterolateral corner injury...do I need surgery
« Reply #5 on: March 25, 2011, 09:04:40 AM »
I've had surgery in both the UK and Germany. My experiences in the UK are based in the West Country and are almost 20 years old, so they would not be much help to you now.

My recommendation would be to look at the list of knee specialists on this site (see the Information Hub). Then follow up with phone calls to their clinics and ask if they have specialists in or with experience of PLC injuries.

The London Knee Clinic would be a good place to start as would the Royal National Orthopaedic Hospital in Stanmore. Both of these centres of excellence would be able to provide you with information with regard to specialists.

As for the arthritis effects - yes one surgeon stated that I already have Grade 4 arthritis in my left knee, another said Grade 3. The surgeon who operated on me last of all and revised all the mess-ups from the preceding 3 years told me that he was expecting to see much more arthritis than he actually found. He said that there was very little evidence of any, which was good to hear. As he found the missed LCL and the fibula head fracture in his very long look around in there, I'm more inclined to believe him than the others!

I worked as a PE teacher in the UK and also an Outdoor Pursuits instructor, so I fully expect to reap the "rewards" of such an active life and the knock on effect of numerous sports injuries. Touch wood though, nothing has shown up yet that has a huge impact on my daily life. I have Depuytren's Syndrome in both hands but that is a genetic problem that has affected all my family (my father, grandfather, brother and sisters all have it in various stages). I'm lucky as I knew what it was when it developed and as yet it has not caused me any problems other than irritation at the gradual loss of strength in my right hand (as I'm fully left-handed it is a minor thing  ;D)

Netball is a booger on the knees isn't it! I was more hockey, volleyball and athletics orientated again all murder on the knees one way or the other as well!  ::) But then over here they say that: Sport ist Mord (Sport is deadly/murder)  ;D


Sue  ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline charl85

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Re: Posterolateral corner injury...do I need surgery
« Reply #6 on: March 25, 2011, 09:31:11 AM »
Ooh, thanks for that. Think I will look for specialists and try and get a referral, as good as my physio is she said that she has seen very few cases and isn't that sure what to do other than compensate the instability with by working other muscles.

You really gave been through it with you hands and knees! I have been very lucky (touch wood) and have had very few injuries. Ruptured ankle ligament (which didn't even have a scan or physio for...a&e.doc thought it would be fine and it was!) and lots of broken fingers. Got off pretty lightly as I was playing and training 10 times a week!  Lucky that I've cut down the level at which I play in last few years so can ease the knee back in gently when its feeling better.

Its such a tough choice, don't want surgery but do want to be able to play sport and long term don't want arthritis! 

Charlotte

Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon

Offline Vickster

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Re: Posterolateral corner injury...do I need surgery
« Reply #7 on: March 25, 2011, 11:48:30 AM »
This guy recently has PCL surgery in the UK.  http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=55672.from1301052582;topicseen#msg540513

Might be worth asking about the surgeon (a Mr Calder, assuming the same chap, looks to be in Leeds though http://www.kneeguru.co.uk/KNEEsurgeon/calder01/contact.php

Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline charl85

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Re: Posterolateral corner injury...do I need surgery
« Reply #8 on: March 25, 2011, 12:51:25 PM »
Thanks for that, will have a look. Maybe tomorrow though, I'm making myself depressed reading about it all...if only there was a miracle cute that didn't involve months of rehab! :o)
Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon

Offline Vickster

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Re: Posterolateral corner injury...do I need surgery
« Reply #9 on: March 25, 2011, 01:08:32 PM »
I think all of us around here wished that! Knees are a b****r  I *only* tore my meniscus, damaged a bit of articular cartilage and bruised the bone...18 months, 2 scopes and I still have pain, cannot kneel or squat, let alone run, jump or hop.  Fortunately, I am not very sporty ;D
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline charl85

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Re: Posterolateral corner injury...do I need surgery
« Reply #10 on: March 25, 2011, 05:10:26 PM »
Ditto, my initial diagnoses was *only* extensive bone bruising to tibial plateau and femur and depression of femoral condyle.  Didn't think that sounded like the best use of the word *only* when the consultant told me. And now they have added all this extra plc stuff and they still don't really know what to do about it.  Only good thing is that atm I'm not in pain in day to day life...fingers crossed that continues!
Oct 10 - Extensive BMO to lateral tibial plateau and depression of femoral condyle (Left knee)

Mar 11 - re-diagnosed with injury to posterolateral corner injury causing external rotation of left tibia. Rehab and possible recon