The Use of Arthroscopy in Diagnosis and Operative Treatment of Knee Posterolateral Corner Injuries: A Narrative Review

Abstract

Injuries to the posterolateral corner (PLC) of the knee represent a complex clinical entity that is frequently underdiagnosed and undertreated, often leading to persistent instability and failure of concomitant ligament reconstructions. Although open surgical approaches to the PLC have been extensively described, the role of arthroscopy in the diagnosis and management of these injuries remains less clearly defined despite increasingly encouraging clinical and biomechanical results. The aim of this narrative review was to analyze the role of knee arthroscopy in the diagnosis, evaluation, and treatment of PLC injuries. A comprehensive literature review was performed focusing on studies investigating arthroscopic findings, diagnostic signs, and arthroscopic or arthroscopy-assisted techniques for PLC management. Relevant clinical, anatomical, biomechanical, and surgical studies were analyzed to provide an integrated arthroscopy-oriented perspective. Arthroscopy enables direct visualization of key posterolateral structures and identification of characteristic diagnostic findings, such as the lateral drive-through sign, potentially improving detection of subtle or combined PLC injuries. In addition, arthroscopic assessment facilitates evaluation of associated intra-articular lesions and may contribute to more accurate characterization of injury patterns. Emerging arthroscopic and arthroscopy-assisted reconstruction techniques may offer advantages in selected cases by supporting tailored surgical strategies, accurate graft positioning, and reduced surgical morbidity. Knee arthroscopy is assuming an increasingly important role in the comprehensive management of PLC injuries, extending beyond the treatment of associated intra-articular pathology alone. Integration of arthroscopy into the diagnostic and therapeutic algorithm of PLC injuries may improve surgical decision-making and patient-specific management. Nevertheless, further high-quality clinical studies are required to establish standardized arthroscopic criteria and validate the long-term clinical advantages of arthroscopy-guided approaches.