TARGETING: KNEE 

Minerva Ortopedica e Traumatologica 2014 April;65(2):125-39

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Recent advances in the treatment of fibular (lateral) collateral ligament injuries

James E. W. ¹, Johannsen A. M. ², LaPrade C. M. ², LaPrade R. F. ^{2, 3} ✉

¹ Center for Outcomes‑based Orthopedic Research, Steadman Philippon Research Institute, Vail, CO, USA; ² Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA; ³ The Steadman Clinic, Vail, CO, USA

The purpose of this review is to highlight recent advances regarding the diagnosis and treatment of fibular (lateral) collateral ligament (FCL) injuries in the knee. The FCL originates just proximal and posterior to the lateral epicondyle on the femur and inserts distally in a bony depression on the lateral aspect of the fibular head. The FCL functions as the primary restraint to varus laxity at all knee flexion angles and as the primary restraint to external rotation when the knee is in extension. Depending on the grade of FCL injury, treatment ranges from non-operative management to surgical reconstruction. For patients with grade I or II (partial) FCL tears, non-operative management consisting of an accelerated physical therapy program is often the first line treatment. Indications for FCL surgical reconstruction include patients with grade III (complete) FCL tears or patients who fail to improve with conservative management. Reconstruction is favored over repair for midsubstance tears due to a reported increased failure rate associated with repair. In addition, reconstruction functions to minimize the risk of complications associated with chronic lateral knee instability such as medial compartment osteoarthritis, medial meniscus tears, and failure of cruciate ligament reconstruction grafts. Outcomes after FCL reconstruction have demonstrated improvement in both subjective and objective measures.