Postero-Medial Corner Injury

Anatomy

 

Layers of the medial knee

 

Layer 1

- sartorius and sartorius fascia

 

Layer 2

- superficial MCL

- posterior oblique ligament

 

Layer 3

- deep MCL (meniscofemoral and meniscotibial ligament)

- posteromedial capsule 

 

MCL

 

Origin

- 3 mm proximal and 5 mm posterior to the epicondyle

 

Insertion

- 6 cm distal to the joint line

 

Xray landmarks

 

Wijdicks et al JBJS Am 2009

- describes radiographic landmarks

- aids reconstruction

 

Management

 

Algorithm

 

Displaced tibial avulsion over pes anserinue

- stener lesion

- requires surgery

 

Avulsed femoral MCL

- reattach / repair

 

Avulsed tibial side

- repair deep meniscotibial ligament with suture anchors

- repair superficial MCL with suture post and ligament washer

- tension at 30 degrees of flexion and varus stress

 

Repair posterior oblique ligament