Posterior Corner Knee Injury - Knee Ligament Injury - Knee - Conditions - Musculoskeletal - What We Treat

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The posterior corner of the knee is a complex area consisting of many structures. The function of this area is to stabilise the knee against forces. It is very rare for a posterior corner knee injury to occur in isolation. Commonly, this type of injury can be associated with anterior cruciate ligament and posterior cruciate ligament injuries. The main structures located here include:

Popliteus muscle and tendon
Popliteofibular ligament
Biceps femoris muscle and tendon
Lateral collateral ligament
Fabellofibular ligament
Arcuate ligament complex
Posterolateral joint capsule

Physiotherapy assessment and treatments ensures that the structures damaged are identified and a specific treatment plan can be put in place in order for the patient to reach the maximum revovery potential.

Above: Therapist performing soft tissue massage on the tissues aound the knee

What causes a posterior corner knee injury?

A posterior corner knee injury can quite commonly be caused by a sporting incident. For example, an athlete who receives an oncoming impact to the inside of a straightened knee may sustain this type of injury. Also, high impact road traffic accidents may cause a posterior corner knee injury. A posterior corner knee injury can be categorised into three groups which are:

Grade I – no major damage or laxity
Grade ll – minimal damage and laxity to the structures
Grade lll – complete disruption of the structures with major disability

The treatment that follows a posterior corner knee injury will depend on what grade it is categorised as. Generally, grade l-ll can be treated conservatively whilst grade lll requires treatment. All grades require physiotherapy treatment in order for the knee to return to pre injury level.

What symptoms caused by a posterior corner knee injury can physiotherapy help with?

Symptoms arising from a posterior corner knee injury that physiotherapy can help with include:

Pain at the back of the knee
Swelling
Decreased strength
Decreased range of movement
Decreased function

If you have any symptoms arising from a posterior corner knee injury then physiotherapy treatment will ensure that your needs are met allowing you to return to function as quickly as possible.

Above: Therapist performing knee assessment

How is a posterior corner knee injury diagnosed?

A detailed subjective and objective assessment will be carried out by a physiotherapist in order to diagnose a posterior corner knee injury. Special tests will be carried out in order to determine what structures are involved. The tests are known as:

Lachman& Posterior drawer tests
Posterolateral Drawer Test
Varus stress test
Dial Test
Reverse Pivot Shift Test
External Rotation Recurvatum Test

The physiotherapist will also carry out various neural tests to determine if any nerves have been damaged. Following this, an MRI scan will be ordered to clarify what structures are involved and the level of damage obtained. An x-ray may be ordered to rule out any fractures.

Medical Treatment

Treatment of a posterior corner knee injury depends on the grade of injury. Normally, grade l and ll injuries can be treated conservatively whereas a grade lll injury will require surgery. Physiotherapy treatment is required for all grades of posterior corner knee injuries in order to restore the knee as best as possible.

There are two different types of surgery available depending on when you sustained your posterior corner knee injury. They are:

Acute injuries - less than three weeks old and can normally be repaired. Liagaments and tendons are sewn back together or are reattached back to the bone.

Chronic injuries - more than three weeks old and require reconstruction. New ligaments and tendons are created using other structures which may include the popliteofibular ligament, the popliteustendonand the lateral collateral ligament.

For six to eight weeks following both types of surgery, partial non weight bearing is instructedand a protective hinged knee brace may be worn to allow the knee to heal. However, physiotherapy treatment can begin straight away with the main focus being on range of motion exercises and strengthening your quadriceps muscles.

Benefits of physiotherapy for a posterior corner knee injury

Physiotherapy treatment following a posterior corner knee injury can help you in many ways including:

Decreasing pain levels
Decreasing swelling
Increasing range of motion
Increasing strength
Gait re-education
Increasingbalance
Returning you to function
Returning you to pre injury activities

Physiotherapy treatment facilitates the recovery process allowing you to reach your optimal recovery potential in the quickest time.

What would physiotherapy treatment for a posterior corner knee injury involve?

Physiotherapy treatment for a posterior corner knee injury depends on the severity of each individual injury. Following surgery, your surgeon will have a rehabilitation protocol for your physiotherapist to be guided by and will generally include:

Walking aid education
Range of movement exercises
Quadriceps strengthening exercises
Soft tissue massage
Gait re-education
Balance practice
Gradual return to function

Each rehabilitation programme is specific to your goals and symptoms. To return to function as quick as possible following a posterior corner knee injury then physiotherapy treatment will allow this to happen.

How do I arrange a physiotherapy assessment for a posterior corner knee injury?

If you or someone you know has sustained a posterior corner knee injury then you can either email us at office@liverpoolphysio.co.uk or call us on 0330 088 7800 to arrange an appointment with one of our specialist musculoskeletal physiotherapists.

Summary

If a posterior corner knee injury is left undiagnosed and untreated then serious consequences can develop.Injuries to the posterior corner of the knee often occur in combination with other ligamentous injuries to the knee. As with any injury, an in-depth understanding of the anatomy and functional interactions of the posterior corner of the knee is critical to diagnosing and treating injuries here. Here at Liverpool Physio our specialist physiotherapists seek for every individual to reach their potential. To book an appointment at Liverpool Physio then you can email us at office@.............. Or call us on…………………..

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