The kinematics of knee joint in different injury degrees of posterior cruciate ligament at full extension

2006 ◽  
Vol 39 ◽  
pp. S497
Author(s):  
C.-H. Wu ◽  
C.-K. Cheng ◽  
J.-J. Liau
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Full Extension

scholarly journals Evaluation of Knee Joint after Open Reduction and Internal Fixation Surgery of Posterior Cruciate Ligament in Patients with Avulsion Fracture

2019 ◽  
Vol 7 (6) ◽  
pp. 982-986
Author(s):  
Navid Salehi ◽  
Faeze Azarifar ◽  
Arman Jahanshahi ◽  
Hamidreza Mohammadi
Keyword(s):  
Knee Joint ◽  
Internal Fixation ◽  
Posterior Cruciate Ligament ◽  
Open Reduction ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Common Mechanism ◽  
Knee Score ◽  
Normal Knee ◽  
Lysholm Knee Score

BACKGROUND: The posterior cruciate ligament is one of the important tissues and structures sustaining the knee joint, and its rupture or detachment may lead to joint instability or destruction. AIM: The present study aimed at investigating the Open Reduction and Internal Fixation surgery of posterior cruciate ligament and comparing it to the normal knee of the same side. METHODS: In this study, 25 patients with avulsion fracture at the PCL joint were treated with open surgery and screw fixation. The patients were followed up by Lysholm knee score for at least 12 months after surgery. RESULTS: All patients were male with an average age of 25 years over the years 2010-2018. The common mechanism of injury in these patients was motorcycle-car accident. In the study with Lysholm knee score, 21 patients (80%) obtained the good score of 60-90 while 20% of patients were placed in the fair group (30-59). The average score was 86. CONCLUSION: The obtained score of knee function questionnaire in this study had no significant difference from other similar studies, and most patients achieved a good and acceptable score after the surgery. There was no knee instability and functional impairment in the patients compared to the normal knee. Considering the clinical results after the fixation of the PCL avulsion fracture causing a significant improvement in patients, the surgery could be considered as an acceptable and effective method for treating such impairment and fracture.

scholarly journals A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
M. Marieswaran ◽  
Ishita Jain ◽  
Bhavuk Garg ◽  
Vijay Sharma ◽  
Dinesh Kalyanasundaram
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Viscoelastic Behavior ◽  
Strain Rates ◽  
Self Healing ◽  
Full Extension ◽  
Human Knee Joint ◽  
Anterior Cruciate ◽  
Synthetic Grafts

The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a) the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b) the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c) a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d) nearly all synthetic grafts have been recalled from the market; and (e) bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the published reviews on the ACL focus largely on animal ACL than human ACL. Further, this review article summarizes the issues with autografts and synthetic grafts used so far. Autografts (patellar tendon and hamstring tendon) remains the gold standard as nearly all synthetic grafts introduced for clinical use have been withdrawn from the market. The mechanical strength during the ligamentization of autografts is also highlighted in this work.

Torsion and Bending Imposed on a New Anterior Cruciate Ligament Prosthesis During Knee Flexion: An Evaluation Method

1984 ◽  
Vol 106 (4) ◽  
pp. 285-294 ◽  
Author(s):  
P. Gely ◽  
G. Drouin ◽  
P. S. Thiry ◽  
G. R. Tremblay
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Flexion ◽  
Input Data ◽  
Evaluation Method ◽  
Cruciate Ligament ◽  
Geometric Model ◽  
Kinematic Model ◽  
Full Extension ◽  
Anterior Cruciate

A new composite prosthesis was recently proposed for the anterior cruciate ligament. It is implanted in the femur and the tibia through two anchoring channels. Its intra-articular portion, composed of a fiber mesh sheath wrapped around a silicons rubber cylindrical core, reproduces satisfactorily the ligament response in tension. However, the prosthesis does not only undergo elongation. In addition, it is submitted to torsion in its intra-articular portion and bending at its ends. This paper presents a new method to evaluate these two types of deformations throughout a knee flexion by means of a geometric model of the implanted prosthesis. Input data originate from two sources: (i) a three-dimensional anatomic topology of the knee joint in full extension, providing the localization of the prosthesis anchoring channels, and ii) a kinematic model of the knee describing the motion of these anchoring channels during a physiological flexion of the knee joint. The evaluation method is independent of the way input data are obtained. This method, applied to a right cadaveric knee, shows that the orientation of the anchoring channels has a large effect on the extent of torsion and bending applied to the implanted prosthesis throughout a knee flexion, especially on the femoral side. The study suggests also the best choice for the anchoring channel axes orientation.

A Two-Dimensional Dynamic Anatomical Model of the Human Knee Joint

1993 ◽  
Vol 115 (4A) ◽  
pp. 357-365 ◽  
Author(s):  
Eihab Abdel-Rahman ◽  
Mohamed Samir Hefzy
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Numerical Solutions ◽  
Cruciate Ligament ◽  
Posterior Part ◽  
Geometric Constraints ◽  
Two Dimensional ◽  
Algebraic Equations ◽  
Collateral Ligaments ◽  
Nonlinear Algebraic Equations

The objective of this study is to develop a two-dimensional dynamic model of the knee joint to simulate its response under sudden impact. The knee joint is modeled as two rigid bodies, representing a fixed femur and a moving tibia, connected by 10 nonlinear springs representing the different fibers of the anterior and posterior cruciate ligaments, the medial and lateral collateral ligaments, and the posterior part of the capsule. In the analysis, the joint profiles were represented by polynomials. Model equations include three nonlinear differential equations of motion and three nonlinear algebraic equations representing the geometric constraints. A single point contact was assumed to exist at all times. Numerical solutions were obtained by applying Newmark constant-average-acceleration scheme of differential approximation to transform the motion equations into a set of nonlinear simultaneous algebraic equations. The equations reduced thus to six nonlinear algebraic equations in six unknowns. The Newton-Raphson iteration technique was then used to obtain the solution. Knee response was determined under sudden rectangular pulsing posterior forces applied to the tibia and having different amplitudes and durations. The results indicate that increasing pulse amplitude and/or duration produced a decrease in the magnitude of the tibio-femoral contact force, indicating thus a reduction in the joint stiffness. It was found that the anterior fibers of the posterior cruciate and the medial collateral ligaments are the primary restraints for a posterior forcing pulse in the range of 20 to 90 degrees of knee flexion; this explains why most isolated posterior cruciate ligament injuries and combined injuries to the posterior cruciate ligament and the medial collateral results from a posterior impact on a flexed knee.

scholarly journals Analisis Informasi Anatomi antara Sekuens T2WI FSE dan Proton Density Fat Saturation pada Pemeriksaan MRI Knee Joint Potongan Sagital (Studi pada Anterior Cruciate Ligament (ACL) dan Posterior Cruciate Ligament (PCL))

2016 ◽  
Vol 2 (2) ◽  
pp. 175-179
Author(s):  
Atina Izzah Kusumaningrum ◽  
Lidya Purna WS Kuntjoro ◽  
Gatot Murti Wibowo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Proton Density ◽  
Border Line ◽  
Fat Saturation ◽  
Anterior Cruciate ◽  
Anatomical Information ◽  
Mri Knee

Background: There are clinical situations that radiology physicians need to assess Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) clearly with the two typical sequences (T2WI FSE sequence and Proton Density Fat Saturation). However, a slight difference in using the applied sequences will result different levels of image quality information. The aim of this study is to compare clinical  manifest in anatomical information on the resulted images between  T2WI FSE sequence and Proton Density Fat Saturation and to define the best sequence that fit to reveal ACL and PCL of the knee joint..Methods: The research was an experimental quasy. 20 sagital slices of  the knee jointMRI were acquired from 10 volunteers who underwent MRI examinations with the two methods (T2WI FSE and Proton Density Fat Saturation). 3 experienced radiology physicians blended in the image scoring when review ACL and PCL appearances on knee MRI images. Inter-observer suitability was checked with Kappa test. A non-parametric Wilcoxon analyses was the statistical tool to test the null hypothesis.Results: The result showed a significant difference in anatomical information of ACL and PCL when T2WI FSE and Proton Density Fat Saturation sequences applied on the MRI of the knee jointsagital slices (p-value 0,05). The mean rank of T2WI FSE was better than Proton Density Fat Saturation  which contributed to the value at 4,50. There was an increase in signals that lead to ACL and PCL appear to be more hyper-intens compared to sorrounding organs in general, except the border line  of PCL.  By this means, it was useful for evaluating the patient whose particularly with ACL post-grafting.Conclusion: There was the difference in anatomical information between T2WI FSE sequence and Proton Density Fat Saturation on MRI knee jointwith sagital slices for ACL and PCL studies.  T2WI FSE sequence was the best method for showing anatomical information of ACL and PCL, although a relative low signal still occured from border line  of PCL.

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