Lesiones del ángulo posterolateral de la rodilla
Resumen
Resumen El ángulo posterolateral (APL) de la rodilla presenta una anatomía compleja que permite mantener la estabilidad frente al varo, la rotación externa y la traslación posterior. Las lesiones del APL suelen pasar desapercibidas. Se relacionan con accidentes de tráfico y deportivos. La exploración física resulta fundamental en el diagnóstico. La gravedad de la lesión determina el tipo de tratamiento, conservador o quirúrgico. El tratamiento quirúrgico se asocia a una alta incidencia de complicaciones, como la artrofibrosis y la pérdida de movilidad. Abstract The posterolateral corner of the knee has a complex anatomy that allows maintaining stability against varus, external rotation and posterior translation. These injuries usually go unnoticed. They are related to traffic accidents and sports. The physical examination is fundamental in the diagnosis. The severity of the injury determines the type of treatment, conservative or surgical. Operative treatment is associated with a high incidence of complications, such as arthrofibrosis and loss of mobility.Citas
Nannaparaju M, Mortada S, Wiik A, Khan W, Alam M. Posterolateral corner injuries: Epidemiology, anatomy, biomechanics and diagnosis. Injury. 2018 Jun;49(6):1024-1031. doi: 10.1016/j.injury.2017.10.008. Epub 2017 Oct 9. Review. PubMed PMID: 29254623. https://www.ncbi.nlm.nih.gov/pubmed/29254623
Shon OJ, Park JW, Kim BJ. Current Concepts of Posterolateral Corner Injuries of the Knee. Knee Surg Relat Res. 2017 Dec 1;29(4):256-268. doi: 10.5792/ksrr.16.029. Review. PubMed PMID: 29172386; PubMed Central PMCID: PMC5718794. https://www.ncbi.nlm.nih.gov/pudmed/29172386
Ridley TJ, McCarthy MA, Bollier MJ, Wolf BR, Amendola A. The incidence and clinical outcomes of peroneal nerve injuries associated with posterolateral corner injuries of the knee. Knee Surg Sports Traumatol Arthrosc. 2018 Mar;26(3):806-811. doi: 10.1007/s00167-016-4417-2. Epub 2017 Feb 3. PubMed PMID: 28160014. https://www.ncbi.nlm.nih.gov/pubmed/28160014
Chahla J, Moatshe G, Dean CS, LaPrade RF. Post4. erolateral Corner of the Knee: Current Concepts. Arch Bone Jt Surg. 2016 Apr;4(2):97-103. PubMed PMID: 27200384; PubMed Central PMCID: PMC4852053. https://www.ncbi.nlm.nih.gov/pubmed/27200384
Dold AP, Swensen S, Strauss E, Alaia M. The Posteromedial Corner of the Knee: Anatomy, Pathology, and Management Strategies. J Am Acad Orthop Surg. 2017 Nov;25(11):752-761. doi: 10.5435/JAAOS-D-16-00020. Review. PubMed PMID: 29059112. https://www.ncbi.nlm.nih.gov/pubmed/29059112
Stinton SK, Siebold R, Freedberg H, Jacobs C, Branch TP. The use of a robotic tibial rotation device and an electromagnetic tracking system to accurately reproduce the clinical dial test. Knee Surg Sports Traumatol Arthrosc. 2016 Mar;24(3):815-22. doi: 10.1007/s00167-016-4042-0. Epub 2016 Feb 18. PubMed PMID: 26891963; PubMed Central PMCID: PMC4769317. https://www.ncbi.nlm.nih.gov/pudmed/26891963
Mook WR, Ligh CA, Moorman CT 3rd, Leversedge FJ. Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm. J Am Acad Orthop Surg. 2013 Jun;21(6):343-54. doi: 10.5435/JAAOS-21-06-343. Review. PubMed PMID: 23728959. https://www.ncbi.nlm.nih.gov/pudmed/23728959
Fay K, Mannem R, Baynes K, Sarin D, DuBois M. Iliotibial band avulsion fracture: a case report with differential diagnosis. Emerg Radiol. 2016 Feb;23(1):93-6. doi: 10.1007/s10140-015-1347-0. Epub 2015 Sep 24. PubMed PMID: 26403089. https://www.ncbi.nlm.nih.gov/pudmed/26403089
Vasilevska Nikodinovska V, Gimber LH, Hardy JC, Taljanovic MS. The Collateral Ligaments and Posterolateral Corner: What Radiologists Should Know. Semin Musculoskelet Radiol. 2016 Feb;20(1):52-64. doi: 10.1055/s-0036-1579677. Epub 2016 Apr 14. Review. PubMed PMID: 27077587. https://www.ncbi.nlm.nih.gov/pudmed/27077587
Sekiya JK, Swaringen JC, Wojtys EM, Jacobson JA. Diagnostic ultrasound evaluation of posterolateral corner knee injuries. Arthroscopy. 2010 Apr;26(4):494-9. doi: 10.1016/j.arthro.2009.08.023. Epub 2010 Feb 11. PubMed PMID: 20362828. https://www.ncbi.nlm.nih.gov/pubmed/20362828
Bonadio MB, Helito CP, Gury LA, Demange MK, Pécora JR, Angelini FJ. Correlation between magnetic resonance imaging and physical exam in assessment of injuries to posterolateral corner of the knee. Acta Ortop Bras. 2014;22(3):124-6. doi: 10.1590/1413-78522014220300928. PubMed PMID: 25061416; PubMed Central PMCID: PMC4108692. https://www.ncbi.nlm.nih.gov/pudmed/25061416
Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am. 1976 Mar;58(2):173-9. PubMed PMID: 1254620. https://www.ncbi.nlm.nih.gov/pubmed/1254620
Fanelli GC. Multiple Ligament Injured Knee: Initial Assessment and Treatment. Clin Sports Med. 2019 Apr;38(2):193-198. doi: 10.1016/j.csm.2018.11.004. Epub 2019 Jan 19. Review. PubMed PMID: 30878043. https://www.ncbi.nlm.nih.gov/pudmed/30878043
Chahla J, Murray IR, Robinson J, Lagae K, Margheritini F, Fritsch B, Leyes M, Barenius B, Pujol N, Engebretsen L, Lind M, Cohen M, Maestu R, Getgood A, Ferrer G, Villascusa S, Uchida S, Levy BA, Von Bormann R, Brown C, Menetrey J, Hantes M, Lording T, Samuelsson K, Frosch KH, Monllau JC, Parker D, LaPrade RF, Gelber PE. Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee Surg Sports Traumatol Arthrosc. 2018 Nov 26. doi: 10.1007/s00167-018-5260-4. [Epub ahead of print]. PubMed PMID: 30478468. https://www.ncbi.nlm.nih.gov/pudmed/30478468
Stannard JP, Stannard JT, Cook JL. Repair or Reconstruction in Acute Posterolateral Instability of the Knee: Decision Making and Surgical Technique Introduction. J Knee Surg. 2015 Dec;28(6):450-4. doi: 10.1055/s-0035-1563403. Epub 2015 Sep 21. PubMed PMID: 26394144. https://www.ncbi.nlm.nih.gov/pubmed/26394144
Moulton SG, Geeslin AG, LaPrade RF. A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 2: Surgical Treatment of Chronic Injuries. Am J Sports Med. 2016 Jun;44(6):1616-23. doi: 10.1177/0363546515593950. Epub 2015 Aug 10. PubMed PMID: 26260463. https://www.ncbi.nlm.nih.gov/pubmed/26260463
Geeslin AG, Moulton SG, LaPrade RF. A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 1: Surgical Treatment of Acute Injuries. Am J Sports Med. 2016 May;44(5):1336-42. doi: 10.1177/0363546515592828. Epub 2015 Aug 10. Review. PubMed PMID: 26260464. https://www.ncbi.nlm.nih.gov/pubmed/26260464
Herman B, Litchfield R, Getgood A. Role of Osteotomy in Posterolateral Instability of the Knee. J Knee Surg. 2015 Dec;28(6):441-9. doi: 10.1055/s-0035-1558856. Epub 2015 Sep 17. Review. PubMed PMID: 26378907. https://www.ncbi.nlm.nih.gov/pubmed/26378907
Apsingi S, Nguyen T, Bull AM, Unwin A, Deehan DJ, Amis AA. A comparison of modified Larson and ‘anatomic’ posterolateral corner reconstructions in knees with combined PCL and posterolateral corner deficiency. Knee Surg Sports Traumatol Arthrosc. 2009 Mar;17(3):305-12. doi: 10.1007/s00167-008-0696-6. Epub 2008 Dec 20. PubMed PMID: 19099290. https://www.ncbi.nlm.nih.gov/pubmed/19099290
Fanelli GC. Surgical treatment of lateral posterolateral instability of the knee using biceps tendon procedures. Sports Med Arthrosc Rev. 2006 Mar;14(1):37-43. Review. PubMed PMID: 17135944.
https://www.ncbi.nlm.nih.gov/pubmed/17135944
Oliveira MG, Severino NR, Kawano CT. Reconstruction of chronic lesions in the posterolateral corner of the knee with autologous biceps femoralis and fascia lata grafts. Clinics (Sao Paulo). 2012;67(6):597-602. PubMed PMID: 22760898; PubMed Central PMCID: PMC3370311. https://www.ncbi.nlm.nih.gov/pubmed/22760898
Larson R. Isometry of the lateral collateral and popliteofibular ligaments and techniques for reconstruction using a free semitendinosus tendon graft. Oper Techn Sports Med.2001;9(2):84–90. https://doi.org/10.1053/otsm.2001.21765
Arciero RA. Anatomic posterolateral corner knee reconstruction. Arthroscopy. 2005 Sep;21(9):1147. PubMed PMID: 16171645.
https://www.ncbi.nlm.nih.gov/pubmed/16171645
Stannard JP, Brown SL, Robinson JT, McGwin G Jr, Volgas DA. Reconstruction of the posterolateral corner of the knee. Arthroscopy. 2005 Sep;21(9):1051-9. PubMed PMID: 16171629. https://www.ncbi.nlm.nih.gov/pubmed/16171629
McCarthy M, Camarda L, Wijdicks CA, Johansen S, Engebretsen L, Laprade RF. Anatomic posterolateral knee reconstructions require a popliteofibular ligament reconstruction through a tibial tunnel. Am J Sports Med. 2010 Aug;38(8):1674-81. doi: 10.1177/0363546510361220. PubMed PMID: 20675651. https://www.ncbi.nlm.nih.gov/pubmed/20675651
Del Gaizo DJ, Della Valle CJ. Instability in primary total knee arthroplasty. Orthopedics. 2011 Sep 9;34(9):e519-21. doi: 10.3928/01477447-20110714-46. PubMed PMID: 21902150. https://www.ncbi.nlm.nih.gov/pudmed/21902150
Cline JT, Alentorn-Geli E, Choi JH, Stuart JJ, Kruger T, Moorman Iii CT. Posterolateral Corner Reconstruction Alone Using a Fibular-Based Technique in a Patient with Persistent Unstable Revision Total Knee Arthroplasty. Case Rep Orthop. 2015;2015:262187. doi: 10.1155/2015/262187. Epub 2015 Dec 31. PubMed PMID: 26881160; PubMed Central PMCID: PMC4735995. https://www.ncbi.nlm.nih.gov/pudmed/26881160
Paget LDA, Kuijer PPFM, Maas M, Kerkhoffs GMMJ. Fast-tracked Rehabilitation and Return to Sport of an Elite Rugby Player with a Complicated Posterolateral Corner Injury and Associated Peroneal Paralysis. BMJ Case Rep. 2017 Oct 27;2017. pii: bcr-2017-219666. doi: 10.1136/bcr-2017-219666. PubMed PMID: 29079672; PubMed Central PMCID: PMC5665361. https://www.ncbi.nlm.nih.gov/pudmed/29079672
MacDonald P. MacDonald P, Vo A. Complications of posterolateral corner injuries of the knee and how to avoid them. Sports Med Arthrosc Rev. 2015 Mar;23(1):51-4. doi: 10.1097/JSA.0000000000000049. Review. PubMed PMID: 25545651. https://www.ncbi.nlm.nih.gov/pudmed/25545651
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).