PLC Injury

PLC or postero-lateral corner injury is the injury to the ligaments of lateral ligamentous complex.

 

PLC injury occurs due to

  • Sudden blow to antero-medial knee.
  • Varus blow to flex knee.
  • Contact and non-contact hyper extension injuries.
  • Knee dislocation.

PLC is an important structure that includes

  • Lateral collateral ligament.
  • Poplitius tendon.
  • Popliteo fibular ligament.
  • Lateral Capsule.

 

Postero lateral complex works synergistically with the PCL to control external rotation, Varus and posterior translation of tibia.

 

Symptoms

 

Patients has instability symptoms when knee is in full extension.

 

Difficulty on stairs, pivoting and cutting.

 

Altered sensation to dorsum of foot and weak ankle dorsiflexion due to associated peroneal nerve injury.

 

Imaging

 

MRI is the investigation of choice to look for injury to LCL, poplitius & biceps tendon.

 

Xray may show an avulsion fracture of the fibular head or femoral condylc.

 

Surgical Reconstruction

 

Anatomical postero-lateral corner reconstruction (Laprade technique).

 

Rehabilitation after PLC reconstruction

 

Week 1-2

 

  • A long knee hinged brace is given immediately after the surgery.
  • Patient is instructed to do passive flexion in prone with the brace locked at 30°.
  • Active flexion should be avoided for 4 weeks.
  • Static quadriceps to be done every 2 hourly to maintain the strength in quads.

 

Week 2-4

 

  • Straight leg raise to be started with the brace on.
  • Passive range of motion – aim 0-60° in 4 weeks.

 

Week 4-6

 

  • Continue stastic quads and leg raises (Aim Rom 0-90°).
  • Partial weight bearing to be started in 6 weeks.

 

Week 6-8

 

Full weight bearing walking.

Initiate active Rom. (knee flexion).

unlock brace, slow transition to wean off brace.

Wall slides & step ups to be started.

 

Week 8-12

Introduce more progressive exercises i.e theraband, partial squats, lunges, stationary cycling.


Warning: file_get_contents(https://plugin.advertroindia.co.in/plugindata.php?id=AI-20192020-00047&type=body): failed to open stream: HTTP request failed! HTTP/1.1 500 Internal Server Error in /home/aosm/public_html/wp-content/themes/bridge/footer.php on line 419