Lateral Knee Injuries: Not Just The Lcl And Meniscus!

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Lateral Knee Injuries: Not Just The Lcl And Meniscus! - Page #4

Working Diagnosis: Anterolateral retinaculum tear with disruption of the IT band Treatment: Surgical Intervention: Right Knee Arthroscopy, Plica Excision, and Open Lateral Retinaculum Repair. Rehab with modified ACL protocol: Weight-bearing 10% for initial 5 weeks; passive ROM not beyond 50 degrees; no patellar mobilization; no movements involving internal or external tibial rotation; quad strengthening and conditioning. Blood flow restriction therapy to enhance quad strengthening. Outcome: The goal was to return 6 months post-op; however, the patient had rehab complications and is still not back to play at 6.5 months post-op. Editor's Comments: The medial and lateral patellar retinacula are ligamentous structures that provide patellofemoral stability. Multiple structures contribute to the the lateral patellar retinaculum, including the iliotibial band, patellofemoral ligament, patellomeniscal ligament, and patellotibial ligament. The lateral patellar retinaculum is injured more often than the medial patellar retinaculum, and may occur by direct trauma, medial patellar subluxation, or tibiofemoral translation (i.e. ACL injury). Injuries to the lateral retinaculum are best visualized by MRI, which may demonstrate disruption of a component ligament, periligamentous edema, or marrow edema at an insertion site (femoral, tibial, or patellar). Concomitant ligament disruption, meniscal tear, cartilage injury, or fracture may occur. References: Thawait et al. Skeletal Radiol. 2012 Feb;41(2):137-48. Return To The Case Studies List.		Back
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