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Posterolateral instability of the knee

D A Ferrari1, J D Ferrari, J Coumas

  • 1University of Massachusetts, Worcester.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1994
PubMed
Summary

Posterolateral knee instability, often challenging to diagnose, may stem from ligament issues. A specific test identified anterior subluxation of the lateral femoral condyle in patients experiencing knee instability.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Knee Biomechanics

Background:

  • Posterolateral knee instability presents diagnostic and therapeutic challenges.
  • It is frequently linked to ligament reconstruction failures and multiple surgical interventions.
  • Patients often report a sensation of the knee giving way.

Purpose of the Study:

  • To describe a specific presentation of posterolateral knee instability.
  • To introduce a novel diagnostic test for this condition.
  • To investigate the underlying biomechanical factors and associated symptoms.

Main Methods:

  • Evaluation of a small cohort of patients with subjective knee instability.
  • Clinical examination including assessment of tibial external rotation at 90 degrees knee flexion.
  • Description and application of a novel standing apprehension test.
  • Radiographic and MRI confirmation of suspected bony abnormalities.

Main Results:

  • Patients exhibited increased tibial external rotation at 90 degrees knee flexion.
  • The described standing apprehension test was positive in all evaluated patients.
  • Anterior subluxation of the lateral femoral condyle was identified in four patients.
  • Medial knee pain was a common associated symptom, potentially linked to soft tissue or nerve stretching.

Conclusions:

  • Posterolateral knee instability can manifest with specific clinical signs, including increased external tibial rotation.
  • The standing apprehension test may aid in diagnosing this condition.
  • Anterior subluxation of the lateral femoral condyle is a potential finding in these patients.
  • Medial knee pain may be referred pain from posteromedial structures or nerve irritation.

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