Acute posterolateral rotatory instability of the knee

J. C. DeLee, M. B. Riley, C. A. Rockwood

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164 Scopus citations


Posterolateral rotatory instability of the knee, a posterior rotational subluxation of the lateral tibial plateau in relation to the lateral femoral condyle, is an unusual condition. Twelve cases of acute posterolateral rotatory instability are presented with an average followup of 7.5 years after surgical repair. Clinical signs suggestive of this injury included posterolateral knee tenderness, and a contusion or abrasion over the anteromedial aspect of the tibia. Indications for operative repair included a 2+ or greater varus instability of the knee at 30° flexion in association with a positive external rotation recurvatum or posterolateral drawer test. At operation, the consistent finding was a tear in the arcuate ligament complex in all patients. Primary operative repair resulted in stable and functional knees in 8 of 11 patients without evidence of degenerative joint disease at 7.5 years postinjury. Roentgenographic evidence of degenerative joint disease was present in three patients, two of whom had some residual posterolateral laxity. Results were evaluated subjectively, objectively, and functionally. There were eight good, three fair, and no poor subjective results; eight good, two fair, and one poor objective results; and seven good, three fair and one poor functional results. The single objective and functional poor result had a deep infection postoperatively. Eight of the 11 patients participated in recreational sports following repair and no patients were limited in the activities of daily living.

Original languageEnglish (US)
Pages (from-to)199-207
Number of pages9
JournalAmerican Journal of Sports Medicine
Issue number4
StatePublished - Jan 1 1983

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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