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Author Topic: Could these symptoms be undiagnosed PLC injury?  (Read 8903 times)

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Offline engineer1

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Could these symptoms be undiagnosed PLC injury?
« on: April 18, 2011, 12:11:03 AM »
I had ACLr 6 months ago. The pre-op MRI showed only a torn ACL and tear in the lateral meniscus.

Over the last few weeks, as I've began to challenge my leg more and more during rehab, I have noticed that I'm still having some perceived laxity with occasional feelings of "partial giving way" of my knee. Most of the episodes and associated pain/tenderness are to the posterior/lateral corner of my knee. All lachman tests on my knee in the last 6 months have shown that my ACLr is fine.

For example, today I was on all fours on the floor when I reached for an object. My knee "clicked", and it felt like it partially gave way. Not nearly as severe as the giving way episodes I used to have before my ACLr (probably because I wasn't on my feet at the time), but enough that it definitely startled me. After a short while, I did have some tenderness behind and above the fibular head, but no swelling of my knee. I've had a few other episodes, but all were while I wasn't fully weight bearing on my leg (taking off shoes, turning/stepping onto good leg, etc).

Does anyone know if assessing the posterolateral corner is a normal step of athroscopic knee surgery? Do you think these symptoms sound like it could be a possibility?

I plan on asking my surgeon these questions when I next see him. I just wanted to get some thoughts from people that have had PLC issues.

Thanks.

Dec 1999 - Tibial Spine/ACL Avulsion Fracture
1999-2010 Chronic ACL Deficiency (stretched)
Feb 2010 - ACL Complete Tear
Oct 2010 - ACL Recon (anterior tibialis allograft)

Offline Reepicheep

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Re: Could these symptoms be undiagnosed PLC injury?
« Reply #1 on: April 28, 2011, 04:52:40 AM »
There is a relatively easy test for PLC injury- it's the Dial test. 

Here's a short video of the dial test being done. If the PLC is damaged, you can dial a person's foot (on injured leg) quite a bit farther than the other.

http://www.youtube.com/watch?v=vzBlb78r0NQ&feature=related

I dislocated my knee back in October.  It was kind of shocking how much farther my injured leg dialed.  My injury included my ACL, PCL, and PLC.  The PCL is rarely reconstructed (sorry if you know all this) when it's not completely ruptured, as was my case.  My doc knew to check my PLC given the nature of my injury.  He reconstructed my plc and 5 months out, my leg feels pretty solid laterally.  I'll always have a PCL sag, but the PLC is good.  I've all but forgotten I had ACL reconstruction, I don't even notice that.   My PLC scar is pretty long and tight, it's taking time to get that flexible.

When people injure their ACL, I think it's a bit uncommon for docs to check the PLC.  This is unfortunate as it will cause major problems to an active person if it's diagnosis is missed.  The aforementioned dial test is a pretty good way to see how your PLC is. 

Best wishes to you.
7/92    LK Meniscectomy
10/10  RK Dislocated
11/10  RK  ACL, Post lateral corner repair