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Skeletal Radiology
Published in: Skeletal Radiology 10/2015

01-10-2015 | Scientific Article

The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

Authors: D. McKean, P. Yoong, S. Yanny, E. Thomee, D. Grant, J. L. Teh, R. Mansour

Published in: Skeletal Radiology | Issue 10/2015

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Abstract

Objective

To describe the patterns of injury associated with injury to the popliteofibular ligament injury.

Materials and methods

A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed.

Results

The mean age was 25.7 years (range, 9–65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn.

Conclusions

PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner.
Literature
1.
2.
Gage BE, McIlvain NM, Collins CL, Fields SK, Comstock RD. Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. Acad Emerg Med: Off J Soc Acad Emerg Med. 2012;19(4):378–85. Epub 2012/04/18.CrossRef
3.
4.
Flandry F, Hommel G. Normal anatomy and biomechanics of the knee. Sports Med Arthroscop Rev. 2011;19(2):82–92. Epub 2011/05/05.CrossRef
5.
6.
Vinson EN, Helms CA. Imaging for evaluation of posterolateral corner injury. J Knee Surg. 2005;18:151–6.CrossRefPubMed
7.
Fanelli GC. Surgical reconstruction for acute posterolateral injury of the knee. J Knee Surg. 2005;18:157–62.CrossRefPubMed
8.
Ross G, DeConciliis GP, Choi K, Scheller AD. Evaluation and treatment of acute posterolateral corner/anterior cruciate ligament injuries of the knee. J Bone Joint Surg. 2004;86-A Suppl 2:2–7.PubMed
9.
Covey DC. Injuries of the posterolateral corner of the knee. J Bone Joint Surg. 2001;83-A:106–18.PubMed
10.
Recondo JA, Salvador E, Villanua JA, Barrera MC, Gervas C, Alustiza JM. Lateral stabilizing structures of the knee: functional anatomy and injuries assessed with MR imaging. Radiographics 2000; 20(Spec No):S91–S102.
11.
Veltri DM, Warren RF. Posterolateral instability of the knee. J Bone Joint Surg. 1994;76-A:460–71.
12.
Haims AH, Medvecky MJ, Pavlovich Jr R, Katz LD. MR imaging of the anatomy of and injuries to the lateral and posterolateral aspects of the knee. AJR Am J Roentgenol. 2003;180(3):647–53. Epub 2003/02/20.CrossRefPubMed
13.
Pacholke DA, Helms CA. MRI of the posterolateral corner injury: a concise review. J Magnet Res Imag : JMRI. 2007;26(2):250–5. Epub 2007/07/12.CrossRef
14.
Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament injuries. II. the lateral compartment. J Bone Joint Surg Am. 1976;58:173–9.PubMed
15.
LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G. The MRI appearance of individual structures of the posterolateral knee. Am J Sports Med. 2000;28:191–9.PubMed
16.
LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003;31:854–60.PubMed
17.
Diamantopoulos A, Tokis A, Tzurbakis M, Patsopoulos I, Georgoulis A. The posterolateral corner of the knee: evaluation under microsurgical dissection. Arthroscopy. 2005;21:826–33.CrossRefPubMed
18.
Moorman 3rd CT, LaPrade RF. Anatomy and biomechanics of the posterolateral corner of the knee. J Knee Surg. 2005;18:137–45.CrossRefPubMed
19.
Maynard MJ, Deng X, Wickiewicz TL, Warren RF. The popliteofibular ligament. Rediscovery of a key element in posterolateral stability. Am J Sports Med. 1996;24:311–6.CrossRefPubMed
20.
Shahane SA, Ibbotson R, Strachan R, Bickerstaff DR. The popliteofibular ligament. An anatomical study of the posterolateral corner of the knee. J Bone Joint Surg (Br). 1999;81:636–42.CrossRef
21.
Wadia FD, Pimple M, Gajjar SM, Narvekar AD. An anatomic study of the popliteofibular ligament. Int Orthop. 2003;27:172–4.PubMedCentralPubMed
22.
Theodorou DJ, Theodorou SJ, Fithian DC, Paxton L, Garelick DH, Resnick D. Posterolateral complex knee injuries: MRI with surgical correlation. Acta Radiol. 2005;46:297–305.CrossRefPubMed
23.
Munshi M, Pretterklieber ML, Kwak S, Antonio GE, Trudell DJ, Resnick D. MR imaging, MR arthrography, and specimen correlation of the posterolateral corner of the knee: an anatomic study. AJR. 2003;180:1095–101.CrossRefPubMed
24.
Rajeswaran G, Lee JC, Healy JC. MRI of the popliteofibular ligament: isotropic 3D WE-DESS versus coronal oblique fat-suppressed T2W MRI. Skeletal Radiol. 2007;36:1141–6.CrossRefPubMed
25.
Yu JS, Salonen DC, Hodler J, Haghighi P, Trudell D, Resnick D. Posterolateral aspect of the knee: improved MRI with a coronal oblique technique. Radiology. 1996;198:199–204.CrossRefPubMed
26.
Vinson EN, Major NM, Helms CA. The posterolateral corner of the knee. AJR Am J Roentgenol. 2008;190(2):449–58. Epub 2008/01/24.CrossRefPubMed
27.
Bolog N, Hodler J. MR imaging of the posterolateral corner of the knee. Skeletal Radiol. 2007;36(8):715–28.CrossRefPubMed
28.
Malone WJ, Koulouris G. MRI of the posterolateral corner of the knee: normal appearance and patterns of injury. Semin Musculoskelet Radiol. 2006;10(3):220–8.CrossRefPubMed
29.
Harish S, O’Donnell P, Connell D, Saifuddin A. Imaging of the posterolateral corner of the knee. Clin Radiol. 2006;61(6):457–66.CrossRefPubMed
30.
Yoon KH, Bae DK, Hah JH, Park SW. Anatomic reconstructive surgery for posterolateral instability of the knee. Arthroscopy. 2006;22(2):159–65.CrossRefPubMed
31.
Arciero RA. Anatomic posterolateral corner knee reconstruction. Arthroscopy. 2005;19:1147.
32.
Ross G, Deconciliis GP, Choi K, Scheller AD. Evaluation and treatment of acute posterolateral corner/anterior cruciate ligament injuries of the knee. J Bone Jt Surg. 2004;86:2–7.
33.
Davies H, Unwin A, Aichroth P. The posterolateral corner of the knee. Anatomy, biomechanics and management of injuries. Injury. 2004;35(1):68–75.CrossRefPubMed
34.
Lee J, Papakonstantinou O, Brookenthal KR, Trudell D, Resnick DL. Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury. Skeletal Radiol. 2003;32(11):619–27.CrossRefPubMed
35.
Cooper JM, McAndrews PT, LaPrade RF. Posterolateral corner injuries of the knee: anatomy, diagnosis and treatment. Sports Med Arthrosc. 2006;14(4):213–20.CrossRefPubMed
36.
Veltri DM, Deng XH, Torzilli PA, Maynard MJ, Warren RF. The role of the popliteofibular ligament in stability of the human knee. A biomechanical study. Am J Sports Med. 1996;24:19–27.CrossRefPubMed
37.
Hayes CW, Brigido MK, Jamadar DA, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics: a review publication of the Radiological Society of North America, Inc. 2000;20 Spec No:S121-34. Epub 2000/10/25.
38.
Mansour R, Yoong P, McKean D, Teh JL. The iliotibial band in acute knee trauma: patterns of injury on MR imaging. Skeletal Radiol. 2014;43(10):1369–75.CrossRefPubMed
Metadata
Title
The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging
Authors
D. McKean
P. Yoong
S. Yanny
E. Thomee
D. Grant
J. L. Teh
R. Mansour
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 10/2015
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2176-7

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