Request an AppointmentCall 469-850-0680

The outer (lateral) side of the knee is stabilized by the lateral collateral ligament (LCL) and a group of structures called the posterolateral corner (PLC), which control the knee against bending outward and twisting. These injuries are much less common than MCL tears, but they are often part of a more serious multi-ligament knee injury, in which two or more major ligaments tear, sometimes with a dislocation of the knee. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, treats LCL, posterolateral corner and multi-ligament knee injuries.

On this page:How it happens · Knee dislocation · Diagnosis · Treatment · Timing · Outcomes · Videos · FAQs · Research
At a glance

  • Caused by high-energy sports injuries, falls or car accidents, or a blow to the inner knee
  • Often combined with ACL or PCL tears
  • A dislocated knee is an emergency because of possible artery and nerve injury
  • Most significant posterolateral corner and multi-ligament injuries do better with surgery
  • Surgery within about 3 weeks is linked to better results

How do these injuries happen?

The LCL and posterolateral corner are injured by a force that pushes the knee outward or twists it with the knee straight, such as a blow to the inner side of the knee or a hyperextension injury. Isolated LCL sprains can happen in sports, but posterolateral corner injuries frequently occur together with tears of the ACL or PCL. Untreated posterolateral and posteromedial corner injuries place extra strain on cruciate ligament reconstructions and can contribute to graft failure.1

Knee dislocation: an emergency

A knee dislocation means the thighbone and shinbone have come apart, tearing several ligaments. It can damage the popliteal artery behind the knee and the peroneal nerve. In a nationwide study, 1.6% of knee dislocations needed emergency surgery for an artery injury.2 The knee may have gone back into place on its own, so any multi-ligament knee injury needs a careful check of the pulses and circulation. Go to an emergency department right away if your knee dislocated or your foot is cold, pale, numb or weak.

Diagnosis

Dr. Dold examines each ligament, including tests for outward opening of the knee and for abnormal rotation, and checks the nerves and blood supply. X-rays look for fractures and avulsion fragments, and an MRI shows each injured structure. Stress X-rays may be used to measure instability.

Treatment

Mild (grade I and II) isolated LCL injuries usually heal with a brace and physical therapy. Complete posterolateral corner injuries and multi-ligament injuries generally need surgery. In systematic reviews, surgically treated multi-ligament knees had better function scores and higher return to work and sport than knees treated without surgery.3,4

Surgery may involve repairing injured structures, reconstructing them with tendon grafts, or both, depending on where and how they tore. The research is important here: reviews found that repair of the posterolateral corner alone failed more often than reconstruction (about 37% to 39% vs 8% to 9%).3,4 Dr. Dold chooses repair, reconstruction or a combination based on your specific injury and reviews these options with you.

Why timing matters

Dr. Dold aims to operate on multi-ligament knee injuries early, usually within about 3 weeks, once the knee is safe for surgery. Reviews found that early surgery was associated with better function scores and motion than delayed surgery.3,4

What to expect

Multi-ligament knee injuries are serious, and recovery is long. In a meta-analysis of 3,571 patients, function scores averaged about 86 out of 100 at 2 years, with a gradual decline over time, and injuries involving the PCL had somewhat lower scores.5 In a review of athletes, about 59% returned to the same or a higher level of sport, 19% returned at a lower level and 22% did not return.6 Rehabilitation is extensive, and Dr. Dold will give you a specific plan based on the structures repaired or reconstructed.

Watch Dr. Dold explain posterolateral corner injuries and surgery

Dr. Dold shares videos on Instagram at @dr.dold.md.

What the research shows

Here is a fuller summary of what published studies show about LCL, posterolateral corner and multi-ligament knee injuries.

Emergency evaluation

Knee dislocations are often part of a larger injury, and the knee may have slipped back into place before you are seen. Trauma reviews recommend checking pulses and the ankle-brachial index, with urgent vascular imaging if they are abnormal. Nerve injury also matters: most partial peroneal nerve injuries recover fully, but recovery after a complete nerve injury is much less predictable.

Repair or reconstruction

For complete (grade III) posterolateral corner injuries, multiple reviews have found reconstruction fails less often than repair alone. Several reconstruction techniques restore stability equally well. Chronic injuries treated with reconstruction have about a 90% success rate across studies.

Timing

Early reconstruction has produced higher function scores than delayed reconstruction in pooled studies. A recent comparative study adds nuance: early surgery may slightly raise the risk of stiffness, but may lower the risk of later arthritis.

Long-term outlook

Surgery gives better function and return to work and sport than non-surgical treatment. Still, these are serious injuries: about 60% of patients return to sport, fewer return to a high level, and long-term studies show that arthritis is common over time.

Why see Dr. Dold

  • Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
  • Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
  • Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
  • Published research on knee ligament and meniscus surgery, including The Posteromedial Corner of the Knee (JAAOS, 2017) and transtibial meniscal root repair (KSSTA, 2017)
  • Team physician and surgical consultant to Rugby Canada; has cared for professional athletes from the NFL, NBA, NHL, MLS, PGA Tour and Major League Rugby
  • D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google

Frequently asked questions

Does an LCL tear need surgery?

Mild isolated LCL sprains usually heal with a brace and therapy. Complete tears, especially with posterolateral corner or cruciate injuries, usually need surgery.3

What is the posterolateral corner?

A group of ligaments and tendons on the outer back of the knee, including the LCL, that controls outward bending and rotation. Injuries there often occur with ACL or PCL tears.1

Is a dislocated knee an emergency?

Yes. It can injure the artery and nerve behind the knee, so it needs an emergency evaluation of circulation and nerve function.2

Should the posterolateral corner be repaired or reconstructed?

It depends on the injury. Reviews found higher failure rates with repair alone than with reconstruction,3,4 so Dr. Dold chooses repair, reconstruction or both based on your specific tear.

How soon should a multi-ligament knee injury be treated?

Usually within about 3 weeks, once the knee is safe for surgery. Early surgery is associated with better function and motion.3,4

Can I return to sport after a multi-ligament knee injury?

Many athletes do. In one review, about 59% returned to the same or a higher level, although recovery takes many months.6

Research cited on this page

  1. Dold AP, Swensen S, Strauss E, Alaia M. The Posteromedial Corner of the Knee: Anatomy, Pathology, and Management Strategies. J Am Acad Orthop Surg. 2017;25(11):752-761. PubMed
  2. Sillanpää PJ, Kannus P, Niemi ST, et al. Incidence of knee dislocation and concomitant vascular injury requiring surgery: a nationwide study. J Trauma Acute Care Surg. 2014;76(3):715-719. PubMed
  3. Levy BA, Dajani KA, Whelan DB, et al. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 2009;25(4):430-438. PubMed
  4. Vicenti G, Solarino G, Carrozzo M, et al. Major concern in the multiligament-injured knee treatment: A systematic review. Injury. 2019;50 Suppl 2:S89-S94. PubMed
  5. Klasan A, Maerz A, Putnis SE, et al. Outcomes after multiligament knee injury worsen over time: A systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2025;33(4):1281-1298. PubMed
  6. D’Ambrosi R, Meena A, Ursino N, et al. Return to Sport After Multiligament Knee Injury: A Systematic Review of the Literature. Indian J Orthop. 2024;58(11):1548-1556. PubMed
  7. Grawe B, Schroeder AJ, Kakazu R, et al. Lateral Collateral Ligament Injury About the Knee: Anatomy, Evaluation, and Management. J Am Acad Orthop Surg. 2018;26(6):e120-e127. PubMed
    A review of LCL injuries described how exam and imaging classify tears, guiding non-surgical care, repair or reconstruction.
  8. Wall C, Byrnes J, Botha L, et al. Acute sport-related knee injuries. Aust J Gen Pract. 2023;52(11):761-766. PubMed
    A review of acute sports knee injuries noted that most isolated collateral ligament injuries can be treated with physiotherapy-led rehabilitation.
  9. Boyce RH, Singh K, Obremskey WT. Acute Management of Traumatic Knee Dislocations for the Generalist. J Am Acad Orthop Surg. 2015;23(12):761-8. PubMed
    A review of acute knee dislocation care recommended urgent vascular imaging when pulses are asymmetric or the ankle-brachial index is below 0.9.
  10. Fanelli GC. Multiple Ligament Injured Knee: Initial Assessment and Treatment. Clin Sports Med. 2019;38(2):193-198. PubMed
    A review emphasized that a knee dislocation is often part of a larger injury pattern that can include blood vessels, nerves and fractures.
  11. Ockuly AC, Imada AO, Richter DL, et al. Initial Evaluation and Classification of Knee Dislocations. Sports Med Arthrosc Rev. 2020;28(3):87-93. PubMed
    A review stressed that a dislocated knee may have reduced on its own before the patient is seen, so a careful vascular check is still needed.
  12. Woodmass JM, Romatowski NP, Esposito JG, et al. A systematic review of peroneal nerve palsy and recovery following traumatic knee dislocation. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2992-3002. PubMed
    After peroneal nerve injury with knee dislocation, most partial palsies recovered fully, but fewer than 40% of complete palsies regained useful function.
  13. Peskun CJ, Whelan DB. Outcomes of operative and nonoperative treatment of multiligament knee injuries: an evidence-based review. Sports Med Arthrosc Rev. 2011;19(2):167-73. PubMed
    A meta-analysis found surgical treatment of multi-ligament knee injuries led to better function and higher return to work and sport than non-surgical care.
  14. Hohmann E, Glatt V, Tetsworth K. Early or delayed reconstruction in multi-ligament knee injuries: A systematic review and meta-analysis. Knee. 2017;24(5):909-916. PubMed
    A meta-analysis found early reconstruction (about 11 days on average) gave higher function scores than delayed reconstruction.
  15. Hoit G, Chahal J, Khan R, et al. Early Compared with Delayed Reconstruction in Multiligament Knee Injury: A Retrospective Propensity Analysis. J Bone Joint Surg Am. 2024;106(20):1903-1909. PubMed
    A 2024 comparative study found early reconstruction may raise the risk of stiffness but may lower the risk of later arthritis compared with delayed reconstruction.
  16. Geeslin AG, Moulton SG, LaPrade RF. A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 1: Surgical Treatment of Acute Injuries. Am J Sports Med. 2016;44(5):1336-42. PubMed
    For acute grade III posterolateral corner injuries, repair had a substantially higher failure rate than reconstruction.
  17. Fortier LM, Knapik DM, Condon JJ, et al. Higher success rate observed in reconstruction techniques of acute posterolateral corner knee injuries as compared to repair: an updated systematic review. Knee Surg Sports Traumatol Arthrosc. 2023;31(12):5565-5578. PubMed
    A 2023 review of acute grade III posterolateral corner injuries found an overall failure rate of about 12%, with lower failure and higher return to sport after reconstruction than repair.
  18. Moulton SG, Geeslin AG, LaPrade RF. A Systematic Review of the Outcomes of Posterolateral Corner Knee Injuries, Part 2: Surgical Treatment of Chronic Injuries. Am J Sports Med. 2016;44(6):1616-23. PubMed
    Reconstruction of chronic posterolateral corner injuries had about a 90% success rate across 15 studies.
  19. Jackson GR, Mameri ES, Condon J, et al. Non-anatomical reconstruction of chronic posterolateral corner knee injuries show failure rates from 0% to 36% versus 4.3% to 24.2% for anatomic reconstruction techniques: An updated systematic review reflecting the 2019 expert consensus statement. J ISAKOS. 2024;9(3):362-370. PubMed
    Failure rates after chronic posterolateral corner reconstruction varied widely, with low revision rates after anatomic techniques.
  20. Yeatts NC, Rao AJ, Trofa DP, et al. Comparable Subjective and Objective Clinical Outcomes After Fibular or Combined Tibial-Fibular-based Reconstruction of the Posterolateral Corner of the Knee: A Systematic Review and Meta-analysis. J Am Acad Orthop Surg Glob Res Rev. 2021;5(12). PubMed
    A meta-analysis found fibular-based and tibiofibular-based posterolateral corner reconstructions gave similar results.
  21. Boksh K, Ghosh A, Narayan P, et al. Fibular- Versus Tibiofibular-Based Reconstruction of the Posterolateral Corner of the Knee: A Systematic Review and Meta-analysis. Am J Sports Med. 2023;51(14):3880-3892. PubMed
    Both fibular-based and tibiofibular-based reconstructions restored varus and rotational stability equally well.
  22. Zielinski KP, Wieland MD, Sequeira SB, et al. Posterolateral Corner Reconstruction: A Systematic Review and Meta-analysis of Biomechanical Studies. Am J Sports Med. 2025;53(6):1524-1534. PubMed
    A 2025 review found no difference in varus or rotational laxity between the two main posterolateral corner reconstruction techniques.
  23. Everhart JS, Du A, Chalasani R, et al. Return to Work or Sport After Multiligament Knee Injury: A Systematic Review of 21 Studies and 524 Patients. Arthroscopy. 2018;34(5):1708-1716. PubMed
    After multi-ligament knee injury, about 60% of surgically treated patients returned to sport, but only 22–33% returned to high-level sport; most returned to work.
  24. Zhang T, Shasti K, Dubina A, et al. Long-Term Outcomes of Multiligament Knee Injuries. J Orthop Trauma. 2022;36(8):394-399. PubMed
    Long-term follow-up of multi-ligament knee injuries found arthritis on X-ray in nearly all knees, with function below population norms.
  25. Randall ZD, Strok MJ, Mazzola JW, et al. The known and unknown reality of knee dislocations: A systematic review. Injury. 2024;55(11):111904. PubMed
    A 2024 review highlighted gaps in long-term outcome data after knee dislocation, including high loss to follow-up.
Ready to get it checked? Request an appointment online or call 469-850-0680. Our staff will contact you by phone and text within an hour of your request (during business hours, Monday–Friday, 8 am–5 pm). Walk-in visits are welcome Monday, Wednesday and Friday, 8:30–10:30 am at 6700 Dallas Parkway, Suite 100, Frisco, TX 75034. We see patients from Frisco, Plano, McKinney, Prosper, Little Elm, The Colony, Allen, Dallas and across North Texas. Same-day appointments available. Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.

Request an AppointmentCall 469-850-0680

Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.