Characterization of posterior capsular injury for preoperative planning in closed knee injuries: A narrative review

Griffin Harris; Arya Kermanshah; Nikhil Patel; William A. Marmor; Michael G. Rizzo; Jean Jose

doi:10.1016/j.jor.2025.07.014

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doi:

10.1016/j.jor.2025.07.014

Characterization of posterior capsular injury for preoperative planning in closed knee injuries: A narrative review

Griffin Harris^a, Arya Kermanshah^a, Nikhil Patel^a, William A. Marmor^b, Michael G. Rizzo^b, Jean Jose^c

a University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA

b University of Miami Miller School of Medicine, Department of Orthopaedics, Miami Dade, FL, USA

c University of Miami Miller School of Medicine, Department of Radiology, Division of Musculoskeletal Radiology, Miami Dade, FL, USA

∗Corresponding author: Griffin Harris. gbh21@miami.edu

Received: 2025-6-13, Accepted: 2025-7-13, Published: 2025-7-15

Disclaimer:
This article was originally published by Reed Elsevier India Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Knee arthroscopy is a common and generally safe procedure for treating ligamentous, meniscal and cartilaginous knee injuries, yet rare complications such as irrigation fluid extravasation and compartment syndrome can occur when the posterior joint capsule is violated. Because posterior capsular injury is often under-recognized on clinical examination and conventional MRI, failure to identify these tears may lead to instability, accelerated cartilage degeneration and functional limitations. In this narrative review, we first outline the complex anatomy of the posterior capsule, including its integration with the semimembranosus and popliteus complexes and attachments to cruciate ligaments, and then characterize key injury mechanisms (multi-ligament tears, pivot-shift, dashboard, hyperextension and valgus “clip” injuries). For each mechanism, we describe characteristic MRI findings, such as focal or gross extracapsular fluid collections, specific bone-bruise patterns and associated ligamentous injuries that should prompt careful evaluation for capsular disruption. We discuss implications for surgical planning, including the trade-offs between early repair (enhanced landmark identification versus increased arthrofibrosis) and delayed intervention (improved capsular healing versus more challenging dissection). Finally, we highlight the need for standardized MRI protocols, reporting templates and risk-stratification tools that integrate imaging findings with injury patterns to guide timing and technique of arthroscopic reconstruction and improve patient outcomes.

Abstract

Highlights

•Under-recognized MRI Signs: Highlights key MRI patterns, from overt extracapsular fluid collections to subtle focal capsular defects—that signal posterior capsule tears.•Mechanism-Specific Imaging Correlates: Defines characteristic bone-bruise distributions and ligament-capsule tear configurations for multi-ligament, pivot-shift, dashboard, hyperextension, and valgus (“clip”) injuries.•ClinicalImpact on Surgical Planning: Emphasizes how identifying posterior capsular disruption guides optimal timing , irrigation-pressure adjustments, and consideration of staged or tailored arthroscopic approaches..

Keywords

Posterior capsular tear

Knee trauma

Magnetic resonance imaging

Fluid extravasation

Compartment syndrome

Multi-ligament knee injury

Bone bruise

Arthroscopic surgical planning

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1 Introduction

Knee arthroscopy is a common orthopaedic procedure in our practice for the treatment of numerous knee ligamentous, meniscal, and cartilaginous pathologies.¹ Although generally safe with low complication rates, we remain alert for rare events, such as infection, thromboembolism, neurovascular injury, and compartment syndrome,²^,³ which we review in our weekly morbidity rounds.

Fluid extravasation with subsequent compartment syndrome of the leg has historically been described as a low-risk but severe complication of knee arthroscopy.³^,⁴ The mechanism involves the violation of the posterior knee joint capsule with extravasation of fluid into surrounding soft tissues, with subsequent elevation of compartment pressures.³^,⁴ It remains unclear if delays in the surgery affect the operative difficulty and patient outcomes in certain traumatic injuries, such as multi-ligament knee injury, a point we continue to review at our center.⁵^,⁶

Without imaging, it is difficult to determine whether the posterior capsule has been violated. Furthermore, the consequences of a missed or underdiagnosed capsular injury include chronic instability, accelerated cartilage damage progressing to osteoarthritis, increased risk of meniscal or ligament injury, synovial effusion, and pain or functional limitations.⁷

The posterior aspect of the knee is anatomically complex and primarily consists of the posterior semimembranosus complex, popliteus complex, and posteromedial joint capsule.⁸ These complexes and the joint capsule are integrated with key intraarticular knee structures, the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), and both menisci.⁸^,⁹ Injury to and mechanisms of injuries associated with these structures may have a higher incidence of posterior capsule disruption.⁶^,¹⁰

Although crucial for preoperative planning, the posterior capsular ligament is often overlooked on MRI;¹¹ recognizing its characteristic injury patterns can confirm capsule rupture and guide surgical intervention. We aimed to identify, in patients with traumatic knee injuries (P), the characteristic MRI features (O) of posterior capsular tears across different injury mechanisms (I/C), based on English-language human studies published between 2000 and 2025 (S).

2 Methods

2.1

2.1 Literature search

We conducted a targeted, narrative literature review to identify studies describing MRI findings of posterior capsular injury in traumatic knee trauma. PubMed, Embase, and Web of Science were searched from January 2000 through May 2025 using combinations of MeSH terms and keywords: ("knee" OR "knee joint") AND ("posterior capsule" OR "posterior capsular") AND ("MRI" OR "magnetic resonance imaging") AND ("injury" OR "tear" OR "rupture"). Searches were limited to English-language human studies.

3 Article selection

We selected articles that (1) provided original MRI characterization of posterior capsular tears, (2) spanned a range of injury mechanisms, and (3) included representative image examples or biomechanical context. Seminal anatomical studies and recent high-impact case series were prioritized.

3.1

3.1 Quality considerations

Although formal risk-of-bias tools were not applied, our team appraised each source for clarity of imaging protocol, sample representativeness, and consistency of reporting.

4 Discussion

4.1

4.1 MRI of the posterior capsule

The knee joint comprises three articular surfaces, the medial and lateral femorotibial and the patellofemoral, and is enclosed by a capsule of an outer fibrous layer and inner synovial membrane. The fibrous capsule spans from the distal femur (up to 6.5 cm proximal) to the proximal tibia (about 1.45 cm distal), though its full extent is often not visualized on imaging¹²; it envelops the condyles and merges with the quadriceps and patellar tendons, while anteriorly the synovial lining reflects beneath the infrapatellar fat pad¹³.

Posterolaterally, the fibrous capsule forms part of the third layer of the posterolateral corner (PLC) alongside the popliteus tendon, fibular collateral ligament (FCL), and popliteofibular ligament (PFL). The oblique popliteal ligament (OPL originates from the posteromedial tibial condyle and integrates fibers from the semimembranosus, and courses obliquely to insert near the fabella or the lateral gastrocnemius tendon.¹⁴^,¹⁵

Posteromedially, the capsule forms the third layer of the posteromedial corner with the deep portion of the MCL, the meniscofemoral and meniscotibial ligaments.¹⁶^,¹⁷ In the three-layer model of De Maeseneer et al., the posterior oblique ligament (POL), the deep medial collateral ligament, and the posterior capsule form the third medial layer, which is reinforced by semimembranosus expansions. Biomechanical testing by D'Ambrosi et al. demonstrates that semimembranosus tension and rotational forces concentrate at the tibial attachment, predisposing the POL and capsule to distal tears^9,18. On MRI, the posterior capsule is best visualized on proton density-weighted sequences, where it appears as intermediate-to-low signal intensity deep to the medial and lateral gastrocnemius tendons (Fig. 1).

Native posterior capsule on PD-weighted MRI on sagittal views laterally (A), intercondylar (B), and medially (C). Note the PD-intermediate intensity of the posterior capsule deep to the hypointense medial and lateral tendons of the gastrocnemius (A & C, red arrows). The posterior capsule is discontinuous in the intercondylar region allowing for passage of neurovascular structures (B, red arrow). Intracapsular fluid collection showing the extent of the capsular reflection without definite rupture (D, red arrow).

Oblique popliteal and posterior oblique ligament tears predominantly occur at their tibial insertions, with distal POL injuries outnumbering proximal ones.¹⁹ These distal tears likely reflect the ligaments’ biomechanical loading during complex trauma; early MRI detection is essential for guiding surgery and preventing chronic instability.

Posterior capsular tears range from gross ruptures with extensive extracapsular fluid to subtle focal leaks (Fig. 2A–D). They often accompany characteristic injury patterns, pivot-shift contusions with ACL tears (Fig. 2B), hyperextension with combined ACL/PCL injury (Fig. 2D), valgus/“clip” mechanisms injuring the MCL (Fig. 2E), and lateral patellar dislocation affecting the anterior capsule (Fig. 2F), that should prompt careful evaluation for capsular disruption.²⁰

A) Multi-ligament injury showing torn ACL (solid arrow) and disruption of the posterior capsule (dotted arrow). Not shown are MCL rupture, popliteofibular and fibulofabellar injuries, fibular collateral ligament injury, and meniscal injury. B) Pivot shift injury showing classic contusions to the posterior tibial condyle (white arrow) and lateral femoral condyle (dotted arrow) with posterior extracapsular fluid suspicious for capsular tear (solid arrow). C) Dashboard injury demonstrating rupture of the posterior capsule with joint fluid extending into the popliteal fossa (solid arrow), PCL rupture (∗), shearing of Hoffa's fat (white arrow), partial thickness tear of the patellar tendon, and large joint effusion. D) Hyperextension injury with classic anterior tibial contusion (dotted arrow), anterior femoral contusion (not shown), and suspected posterior capsular tear. E) Clip injury showing lateral tibial condyle contusion (solid arrow) with MCL avulsion and suspected capsule injury with extra-capsular fluid (dotted arrow). F) Lateral patellar dislocation with tear of the medial patellar retinaculum likely representing anterior capsule tear (solid arrow). Not shown are patellar tendon partial tear, medial patellar and lateral femoral contusions.

4.2

4.2 Multi-ligament injury

Multi-ligament knee injuries may be defined as disruption of two or more of the four major ligaments of the knee and are associated with a high level of morbidity and mortality.¹³ Multi-ligament injuries compromise stability, raising dislocation, vascular injury, and poor outcome risks, and thus often prompt acute arthroscopic management. However, when the posterior capsule is disrupted, surgeons may delay intervention over concerns of fluid extravasation and compartment syndrome (Fig. 2A).¹⁸ Although surgery is sometimes postponed 10–15 days to permit capsular healing, timing remains controversial; early intervention (within three weeks) improves landmark identification, limits meniscal and chondral damage, and yields better outcomes for bony avulsion and ligament repairs.²¹ However, early surgery increases arthrofibrosis, postoperative stiffness, and manipulation requirements,²² whereas delaying beyond three weeks may reduce stiffness and allow capsular healing but complicate dissection and structure identification.²¹

Expert opinion on timing varies, but a staged approach, early repair of extra-articular ligaments (e.g., MCL) followed by delayed reconstruction of intra-articular ligaments (ACL, PCL), may offer the best of both worlds: immediate stability, reduced stiffness risk, and safer intra-articular work after capsular healing²³. Although late intervention can reduce swelling, improve preoperative range of motion, and harness intrinsic healing, it may also promote scar formation and impair postoperative outcomes.²⁴ Identifying posterior capsule injury in multiligament tears can tailor surgical timing, and a staged approach, early capsular repair followed by structured rehabilitation, may optimize outcomes.²⁴ Although Extra-articular ligamentous treatments may prove beneficial in multi-ligament injuries, staged intra-articular treatment may reduce risk of arthrofibrosis and improve overall outcomes.²⁵

4.3

4.3 Pivot shift injury

Pivot shift injuries of the knee are characterized by external rotation of the tibia, internal rotation of the femur, and traction of the quadriceps muscle in the setting of a valgus force. The injury is often produced by a non-contact force and is common in sports that require sudden pivoting of the knee.²⁶

The forces generated from this motion can result in acute rupture of the ACL as well as capsular injury and associated medial and lateral compartment bone lesion findings on MRI.²⁶^,²⁷ Pivot‐shift injuries characteristically produce a lateral‐compartment coup bone bruise from anterior tibial translation, followed by a medial‐compartment countercoup bruise on reduction(Fig. 2B).²⁸^,²⁹

Pivot shift mechanisms may also injure key posterolateral corner (PLC) structures, including the popliteus tendon, arcuate complex, and lateral capsule, which resist varus and external rotation forces.²⁰

The popliteus tendon, a dynamic stabilizer of the PLC, can show increased T2 signal or fiber discontinuity on MRI in cases of partial or complete tearing.³⁰ The arcuate complex, comprising the arcuate ligament, lateral collateral ligament (LCL), and popliteofibular ligament, is often disrupted in pivot-shift injuries, with the LCL most frequently torn or avulsed. Injured lateral capsule reinforced by the arcuate ligament may show thickening, edema, or discontinuity on MRI. Recognizing these findings is essential for accurate diagnosis and surgical planning.³⁰^,³¹ Additional MRI findings, such as pericapsular edema and soft-tissue swelling, underscore the need to carefully assess posterior capsule integrity in pivot-shift injuries(Fig. 3).

Illustration highlights the external rotation of the tibia with simultaneous internal rotation of the femur usually in a non-contact planted injury. A common finding in pivot shift injuries is the presence of a posterolateral tibial plateau bony contusion as a result of ACL disruption permitting anterior translation of the tibia during the mechanism of injury.

Bone lesions in pivot shift injuries present as hyperintensities in T2-weighted, proton-density weighted, fat-suppressed fast spin-echo or short tau inversion recovery images.²⁷ Bone bruises are more conspicuous on T2-weighted than on T1-weighted MRI, where they appear as ill-defined low-signal areas, and gadolinium contrast can further highlight these vascular lesions.²⁷^,³²

4.4

4.4 Dashboard injury

Dashboard injuries occur when a posteriorly directed force on a flexed knee drives the tibia against the femur, commonly in car collisions or falls, and frequently tears the PCL, a primary restraint to posterior tibial translation.³³

Dashboard injuries present on sagittal MRI as shearing of the PCL with or without the involvement of the posterior capsule. Bone lesions in dashboard injuries usually present as hyperintensities of the anterior tibia on T2 weighted imaging.¹¹^,²⁷ Consistent with common MRI findings in dashboard injuries, Fig. 2C demonstrates significant damage to the posterior capsule alongside PCL rupture, Hoffa's fat pad shearing, and anterior tibial contusion.²⁷

In dashboard injuries, damage often extends to the posterior horn of the medial meniscus and its meniscotibial and meniscocapsular attachments; ramp lesions, tears at the posterior meniscocapsular junction, are common and drive posteromedial instability.³⁴ Ramp lesions appear on sagittal MRI as high signal or irregular separation at the meniscocapsular junction with posterior medial tibial plateau contusions.³⁵ MRI sensitivity is moderate (71.7%) and specificity high (90.5%), improving with 3-T scanners. Surgically, accurate detection is crucial, untreated ramp lesions (Fig. 4) accelerate cartilage degeneration and instability, so unstable tears identified on arthroscopic probing should be repaired.³⁶

Drawing depicts the forces and structures involved in a dashboard injury. Traditionally there is an anterior force (such as a car dashboard) on the proximal tibia that results in posterior subluxation of the tibia and resulting rupture of the PCL and potentially the posterior capsule.

4.5

4.5 Hyperextension injury

Hyperextension injuries occur when a force drives the anterior tibia posteriorly against a fully extended, planted knee, such as falling onto a fixed foot or a forceful kick, and this posterior translation can rupture the posterior capsule.¹⁰ On MRI, hyperextension injuries produce symmetrical “kissing” contusions on the anterior tibial plateau and corresponding femoral condyle²⁸^,²⁹; Fig. 2D then demonstrates posterior capsule rupture in this context.²⁸^,²⁹

Hyperextension subjects the PCL, ACL, posterior capsule, and posterior meniscal horn to extreme stress,³⁷ often tearing the thin, perforated intercondylar capsule. On T2-weighted MRI, these tears appear as focal (Fig. 5) high-signal defects with accompanying anteromedial and anterolateral tibial-plateau bone contusions.³⁸

This illustration depicts the bony and ligamentous structures involved in a hyperextension injury. Notice the loss of posterior capsular integrity. Highlighted is the typical “kissing contusion” pattern on the anterior aspect on both the anterior femoral condyles and anterior tibial.

The posterior septum may be torn in complex multiligament injuries, appearing on MRI as focal disruption or increased signal within its normally low-signal fibrous band.¹⁹ Ramp lesions, tears at the posterior meniscocapsular junction, present as high-T2 signal clefts or fluid tracking between the medial meniscus and capsule.³⁹

4.6

4.6 Clip injury

Clip injuries result from valgus loading of a knee flexed 10–30°, commonly occurring in sports such as football and skiing.²⁴ The valgus force applies stress to the medial collateral ligament (MCL) and the posteromedial capsule of the knee, commonly causing MCL tears and associated capsular injuries.⁸ The deep MCL, a capsular thickening continuous with the posterior capsule, is most vulnerable in full extension, when tension peaks in these structures.⁸

Anatomically, the deep MCL resists valgus and contributes to anterior–posterior stability via its meniscofemoral and meniscotibial bands.⁴⁰ The posteromedial capsule, reinforced by the semimembranosus and oblique popliteal ligaments, adds secondary restraint to valgus, internal rotation, and posterior translation.⁴¹ A capsular thickening, the POL controls internal rotation and valgus to prevent anteromedial rotatory instability.⁴¹

In valgus (“clip”) injuries, MRI often shows deep MCL tears of the meniscofemoral or meniscotibial fibers with medial femoral condyle impaction.⁴² Posteromedial capsule disruptions, tears of the semimembranosus insertion or oblique popliteal ligament, and distal POL ruptures frequently (Fig. 6) coexist, alongside medial meniscal and capsular pathology.¹⁹^,⁴³

This illustration depicts the bony and ligamentous structures valgus force involved in a clip injury, typically when the knee is in mild flexion. The medial structures such as the medial collateral ligament and by association the medial knee capsule are more susceptible to trauma.

MRI typically shows lateral femoral condyle contusions and medial condylar bruising from MCL avulsion (Fig. 2E).⁴⁴ It may also reveal medial joint–line fluid tracking and discontinuity of the deep MCL, medial capsule, or POL,¹⁹^,⁴²^,⁴³^,⁴⁵ and bone marrow edema in the lateral condyle and tibial plateau.⁴⁴

The biomechanical forces, associated structural injuries, characteristic MRI findings, and surgical considerations for pivot shift, dashboard, hyperextension, and clip injuries are summarized in Table 1 to facilitate structured evaluation of posterior capsule injury and inform operative planning.

Table 1 Summary of posterior capsule injury patterns across common knee trauma mechanisms, including key biomechanical forces, associated structures, MRI findings, and surgical considerations.

Injury Mechanism	Primary Forces	Structures Commonly Injured	MRI Findings	Surgical Considerations
Pivot Shift	Valgus force + rotational torque with planted foot	ACL, Posterior capsule, Popliteus tendon, Arcuate complex, LCL	Posterolateral tibial plateau contusion, Posterior fluid, Capsular discontinuity	Assess PLC and capsule integrity; guide ACL reconstruction timing
Dashboard	Posterior-directed force on tibia in flexed knee	PCL, Posterior capsule, PHMM, Meniscocapsular junction (ramp lesion)	Anterior tibial contusion, PCL tear, Posterior capsule tear, Ramp lesion	Delayed surgery may reduce fluid extravasation risk; ramp repair if unstable
Hyperextension	Forced terminal extension with axial load	ACL, PCL, Posterior capsule, Posterior septum, Posterior horn of menisci	Anterior femoral and tibial “kissing” contusions, Posterior capsule edema or rupture, Meniscocapsular separation	Balance timing vs. arthrofibrosis risk; identify posterior capsule status pre-op
Clip Injury	Valgus stress in mild flexion	sMCL, dMCL, POL, Posteromedial capsule, Medial meniscus	Lateral femoral condyle contusion, dMCL/POL thickening or tear, Medial capsular disruption	Staged repair for medial structures; POL/dMCL integrity impacts rotational stability

4.6.1

4.6.1 Conflicting evidence

•Reported MRI sensitivity for detecting subtle posterior capsular defects ranges widely, from around 60% on 1.5 T scanners to over 90% in small 3 T cohorts, likely reflecting differences in sequence parameters, timing of imaging relative to injury, and reader experience.•The optimal MRI protocol remains unsettled: some authors advocate proton‐density–weighted fat-suppressed sequences for leak visualization, while others find that T2-weighted or contrast-enhanced studies better delineate small tears.

4.7

4.7 Limitations

•Study‐level: Nearly all data derive from retrospective case series with variable field strengths, heterogeneous imaging protocols, and minimal reporting of inter-reader reliability. Lack of standardized definitions for “capsular tear” further hampers comparison.•Review-level: As a narrative synthesis, we did not perform formal risk-of-bias assessments, quantitative pooling, or exhaustive retrieval of gray literature. Language and publication biases may have excluded relevant non-English or unpublished findings.

5 Conclusion

Posterior capsule integrity is critical to planning arthroscopic reconstruction after knee trauma; routine preoperative MRI in multi-ligament tears, characteristic bone-bruise patterns, or clinical rotational instability should include careful assessment for capsular disruption. Early surgery (<3 weeks) facilitates anatomic repair and landmark identification but increases arthrofibrosis risk, whereas delayed intervention (>3 weeks) may reduce stiffness at the expense of more challenging dissection. Recognizing posterior capsule injury informs surgical timing, irrigation-pressure adjustments, and consideration of staged or delayed approaches to minimize complications. Future research must clarify how capsular disruption affects functional recovery and osteoarthritis progression, standardize MRI protocols and reporting, and develop risk-stratification tools that integrate imaging findings, injury mechanisms, and ligamentous patterns for tailored surgical decision-making.

CRediT authorship contribution statement

Griffin Harris: Conceptualization, Writing – original draft, Investigation, Resources, Supervision. Arya Kermanshah: Writing – review & editing, Methodology, Project administration, Supervision. Nikhil Patel: Formal analysis, Validation, Visualization. William A. Marmor: Resources, Investigation. Michael G. Rizzo: Validation, Project administration, Writing – review & editing. Jean Jose: Formal analysis, Visualization, Project administration, Writing – review & editing.

Ethics

As a narrative review of previously published, de-identified data, this study required no institutional ethics approval. For all clinical images, written informed consent was obtained from the patient or their legal guardian in accordance with the Declaration of Helsinki.

Funding financial support and sponsorship

This narrative review received no external funding, and no financial support or sponsorship was received for this work. Institutional library resources supported literature access.

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Noyes F.R., Clark O., Nolan J., Johnson D.J., . Functional interaction of the cruciate ligaments, posteromedial and posterolateral capsule, oblique popliteal ligament, and other structures in preventing abnormal knee hyperextension. Am J Sports Med. 2023;51(5):1146-1154.
[Google Scholar]
Ali A.M., Pillai J.K., Gulati V., Gibbons C.E.R., Roberton B.J., . Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury? Skelet Radiol. 2018;47(2):173-179.
[Google Scholar]
Salman R., Ditzler M.G., Jadhav S.P., Schallert E.K., McKay S.D., Kan J.H., . Medial meniscal posterior horn tears and ramp lesions in pediatric patients: lessons learned. Pediatr Radiol. 2023;53(12):2345-2354.
[Google Scholar]
Wijdicks C.A., Griffith C.J., Johansen S., Engebretsen L., LaPrade R.F., . Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am. 2010;92(5):1266-1280.
[Google Scholar]
Robinson J.R., Bull A.M.J., Thomas R.R.D., Amis A.A., . The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med. 2006;34(11):1815-1823.
[Google Scholar]
Cristiani R., van de Bunt F., Kvist J., Stålman A., . High prevalence of superficial and deep medial collateral ligament injuries on magnetic resonance imaging in patients with anterior cruciate ligament tears. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2024;40(1):103-110.
[Google Scholar]
Chahal J., Al-Taki M., Pearce D., Leibenberg A., Whelan D.B., . Injury patterns to the posteromedial corner of the knee in high-grade multiligament knee injuries: a MRI study. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2010;18(8):1098-1104.
[Google Scholar]
Sanders T.G., Medynski M.A., Feller J.F., Lawhorn K.W., . Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000;20(suppl_1):S135-S151.
[Google Scholar]
Willinger L., Balendra G., Pai V., et al . High incidence of superficial and deep medial collateral ligament injuries in “isolated” anterior cruciate ligament ruptures: a long overlooked injury. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2022;30(1):167-175.
[Google Scholar]

Introduction

Methods

Literature search

Article selection

Quality considerations

Discussion

MRI of the posterior capsule
Multi-ligament injury
Pivot shift injury
Dashboard injury
Hyperextension injury
Clip injury
Limitations

Conclusion

CRediT authorship contribution statement

Guardian/patient's consent

Ethics

Funding financial support and sponsorship

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[Google Scholar]

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[Google Scholar]

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[Google Scholar]

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[Google Scholar]

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[Google Scholar]

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[Google Scholar]

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Characterization of posterior capsular injury for preoperative planning in closed knee injuries: A narrative review

Abstract

Abstract

Abstract