Does an LCL or posterolateral corner injury need surgery?

When non-surgical treatment is reasonable

Low-grade injuries, where the ligament is stretched or partly torn but the knee is stable on examination and stress X-rays, are usually treated with a hinged brace, crutches for a short period and a structured rehabilitation programme. Regular review checks that stability is maintained as activity increases.

Why complete tears are different

Unlike the MCL on the inner side, the outer-side structures heal less reliably once fully torn. A knee left with significant posterolateral laxity may wobble outward when walking, feel unstable on stairs and put extra strain on the cartilage and on any cruciate graft. For this reason, high-grade injuries in active patients are usually treated surgically.

Repair or reconstruction

• Repair: in the first few weeks, structures torn off bone, such as an LCL or biceps tendon avulsion from the fibular head, can sometimes be reattached with anchors or screws, often with reinforcement
• Reconstruction: when tissues are torn in their mid-substance or the injury is older, the key structures are rebuilt with tendon grafts fixed in bone tunnels
• Combined surgery: ACL or PCL reconstruction is often performed in the same operation

In chronic cases with a bow-legged alignment, an osteotomy to correct alignment may be recommended first, because a graft placed in a varus knee is under constant stretch.

Timing and planning at Aman Hospital

Because the opportunity for straightforward repair is time-sensitive, outer-side injuries are assessed promptly. Dr. Gelber plans surgery once swelling has settled and the knee is moving reasonably well, balancing the benefit of early repair against the risk of stiffness. The plan is discussed in detail, including rehabilitation and the time away from work and sport.