scholarly journals What Kinds of Posterior Cruciate Ligament Bundles Are Preserved in Cruciate-Retaining Total Knee Arthroplasty? A Three-Dimensional Morphology Study

2018 ◽  
Vol 32 (10) ◽  
pp. 989-994
Author(s):  
Yoshinori Inou ◽  
Tetsuya Tomita ◽  
Dai Kiyotomo ◽  
Hideki Yoshikawa ◽  
Kazuomi Sugamoto
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Surface Registration ◽  
Cruciate Retaining ◽  
Tibial Bone ◽  
Total Knee

AbstractIn this study, the effects of tibial bone cutting on the attachment area of the posterior cruciate ligament (PCL), including both the anterolateral bundle (ALB) and posteromedial bundle (PMB), in cruciate-retaining total knee arthroplasty (CR-TKA) were simulated using a three-dimensional (3D) model of the tibial reconstruction. A total of 40 knees with medial osteoarthritis in patients scheduled for TKA were evaluated. Following surface registration of 3D computed tomography (CT) and 3D magnetic resonance imaging (MRI) models of the tibia with the PCL, the area of PCL attachment was calculated. Tibial bone cutting in the 3D CT model was simulated at 8 and 10 mm distal to the center of the lateral articular surfaces of the tibia and with posterior tibial slope angles of 0, 7, and 10 degrees. The percentages of the ALB and PMB tibial attachment areas that remained after cutting at 8 mm were, respectively, 21.8 ± 19.7% and 86.3 ± 17.7% with 0 degrees, 9.5 ± 10.4% and 64.1 ± 23.6% with 7 degrees, and 8.1 ± 6.7% and 51 ± 25.3% with 10 degrees. These results suggest that only half of the PCL attachment area was left after the bone cut simulation. Complete preservation of the ALB and PMB attachment areas requires appropriate selection of surgical procedures and devices.

scholarly journals A Surgical Reduction Technique for Posterior Cruciate Ligament Avulsion Fracture in Total Knee Arthroplasty: A Comparison Study

2020 ◽  
Author(s):  
Wei Lin ◽  
Jinghui Niu ◽  
Yike Dai ◽  
Huaxing Zhang ◽  
Jing Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Cruciate Retaining ◽  
Total Knee ◽  
The Mean ◽  
Pcl Avulsion

Abstract Background: Posterior cruciate ligament (PCL) avulsion fracture of tibia is an uncommon but serious complication during primary cruciate retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.Methods: From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibia in primary cruciate-retaining TKA were included in study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA but no PCL avulsion fracture occurred. Range of motion of the knee and Knee Society Scores were assessed. The forgotten joint score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.Results: In our series, the incidence of PCL avulsion fracture was 4.6%. There was no significant differences with regard to preoperative or postoperative range of motion of the knee (p > 0.05). At the final follow-up of 4 years, the mean clinical scores of study and control groups were 92.4±2.7 and 93.6±1.9, respectively (p > 0.05). The mean functional scores were 85.1±1.8 and 87.1±1.2, respectively (p > 0.05). There was no significant statistical difference with regard to forgotten joint score (p > 0.05). Conclusions: The incidence of PCL avulsion fracture of tibia is relatively high. Older age and female gender were two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with high-strength line can achieve good stability and function of the knee.

scholarly journals A Surgical Reduction Technique for Posterior Cruciate Ligament Avulsion Fracture in Total Knee Arthroplasty: A Comparison Study

2020 ◽  
Author(s):  
Wei Lin ◽  
Jinghui Niu ◽  
Yike Dai ◽  
Huaxing Zhang ◽  
Jing Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Pcl Avulsion

Abstract Background: Posterior cruciate ligament (PCL) avulsion fracture of tibia is an uncommon but serious complication during primary cruciate retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.Methods: From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibia in primary cruciate-retaining TKA were included in study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA but no PCL avulsion fracture occurred. Range of motion of the knee and Knee Society Scores were assessed. The forgotten joint score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.Results: In our series, the incidence of PCL avulsion fracture was 4.6%. There was no significant differences (p > 0.05) with regard to preoperative or postoperative range of motion of the knee, final 4 year mean clinical score in study and control groups 92.4 ± 2.7 and 93.6 ± 1.9, respectively, and mean functional scores of 85.1 ± 1.8 and 87.1 ± 1.2, respectively.Conclusions: The incidence of PCL avulsion fracture of tibia is relatively high. Older age and female gender were two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with high-strength line can achieve good stability and function of the knee.

scholarly journals A Surgical Reduction Technique for Posterior Cruciate Ligament Avulsion Fracture in Total Knee Arthroplasty: A Comparison Study

2020 ◽  
Author(s):  
Wei Lin ◽  
Jinghui Niu ◽  
Yike Dai ◽  
Huaxing Zhang ◽  
Jing Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Cruciate Retaining ◽  
Total Knee ◽  
The Mean ◽  
Pcl Avulsion

Abstract Background: Posterior cruciate ligament (PCL) avulsion fracture of tibia is an uncommon but serious complication during primary cruciate retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.Methods: From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibia in primary cruciate-retaining TKA were included in study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA but no PCL avulsion fracture occurred. Range of motion of the knee and Knee Society Scores were assessed. The forgotten joint score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.Results: In our series, the incidence of PCL avulsion fracture was 4.6%. There was no significant differences with regard to preoperative or postoperative range of motion of the knee (p > 0.05). At the final follow-up of 4 years, the mean clinical scores of study and control groups were 92.4±2.7 and 93.6±1.9, respectively (p > 0.05). The mean functional scores were 85.1±1.8 and 87.1±1.2, respectively (p > 0.05). There was no significant statistical difference with regard to forgotten joint score (p > 0.05). Conclusions: The incidence of PCL avulsion fracture of tibia is relatively high. Older age and female gender were two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with high-strength line can achieve good stability and function of the knee.

scholarly journals The effect of sacrificing the posterior cruciate ligament on total knee arthroplasty with cruciate retaining highly congruent rotating platform prosthesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Long Chen ◽  
Jie Xu ◽  
Yuan Lin ◽  
Fen Qi Luo ◽  
Yu Guo Yu
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Rotating Platform ◽  
Cruciate Retaining ◽  
Significant Difference ◽  
Total Knee ◽  
Hss Score ◽  
Bearing Dislocation

Abstract Objective To analyze the effect of sacrificing the posterior cruciate ligament (PCL) on the early postoperative outcome of cruciate retaining (CR) highly congruent rotating platform TKA. Methods From May 2018 to September 2019, 105 cases of total knee arthroplasty (TKA) with CR highly congruent rotating platform prosthesis were retrospectively analyzed. According to the tension of posterior cruciate ligament, they were divided into sacrifice group (29 cases, 27.6%) and retention group (76 cases, 72.4%). Preoperative and postoperative The Hospital for Special Surgery (HSS) score, range of motion (ROM) were compared between the two groups. In addition, postoperative infection, prosthesis loosening, bearing dislocation, and other complications were also compared. Results All patients were followed up for 11~24 months (mean 18.14 ± 3.52) months. There was no significant difference in general data, preoperative HSS score, and ROM between the two groups (P > 0.05). At the last follow-up, HSS score and ROM of the two groups were better than those before operation (P < 0.05). However, there was no significant difference between the two groups (P > 0.05). Moreover, there were no complications such as infection, loosening of prosthesis, and bearing dislocation in all cases. Conclusion In CR, highly congruent rotating platform TKA with or without tension of the PCL can achieve satisfactory outcomes. Tension-free PCL do not cause joint instability.

Tight posterior cruciate ligament in posterior cruciate-retaining total knee arthroplasty:

2003 ◽  
Vol 18 (5) ◽  
pp. 570-574 ◽  
Author(s):  
Kotaro Yamakado ◽  
Richard L Worland ◽  
Douglas E Jessup ◽  
Efrain Diaz-Borjon ◽  
Roque Pinilla
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Cruciate Retaining ◽  
Total Knee

Influence of Variation in Sagittal Placement of the Femoral Component after Cruciate-Retaining Total-Knee Arthroplasty

2019 ◽  
Author(s):  
Yong-Gon Koh ◽  
Hyoung-Taek Hong ◽  
Hwa-Yong Lee ◽  
Hyo-Jeong Kim ◽  
Kyoung-Tak Kang
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Femoral Component ◽  
Contact Force ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Quadriceps Force ◽  
Femoral Component Flexion

AbstractProsthetic alignment is an important factor for long-term survival in cruciate-retaining (CR) total knee arthroplasty (TKA). The purpose of this study is to investigate the influence of sagittal placement of the femoral component on tibiofemoral (TF) kinematics and kinetics in CR-TKA. Five sagittal placements of femoral component models with −3, 0, 3, 5, and 7 degrees of flexion are developed. The TF joint kinematics, quadriceps force, patellofemoral contact force, and posterior cruciate ligament force are evaluated using the models under deep knee-bend loading. The kinematics of posterior TF translation is found to occur with the increase in femoral-component flexion. The quadriceps force and patellofemoral contact force decrease with the femoral-component flexion increase. In addition, extension of the femoral component increases with the increase in posterior cruciate ligament force. The flexed femoral component in CR-TKA provides a positive biomechanical effect compared with a neutral position. Slight flexion could be an effective alternative technique to enable positive biomechanical effects with TKA prostheses.

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