scholarly journals Long-term outcomes after arthroscopic single-bundle reconstruction of the posterior cruciate ligament: A 7-year follow-up study

2017 ◽  
Vol 46 (2) ◽  
pp. 865-872 ◽  
Author(s):  
Rui Wang ◽  
Bin Xu ◽  
Lei Wu ◽  
Honggang Xu
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Single Bundle ◽  
Long Term Outcomes ◽  
Pcl Reconstruction ◽  
Lysholm Knee Score ◽  
The Stability ◽  
Tegner Score

Objective Arthroscopy is the most popular technique in posterior cruciate ligament (PCL) reconstruction surgery. However, no consensus on long-term outcomes after arthroscopic PCL reconstruction has been reached. This study was performed to evaluate the long-term outcomes after arthroscopic autologous hamstring or allogeneic tendon single-bundle reconstruction of the PCL. Methods Fifty-eight patients who underwent arthroscopic PCL reconstruction in Anhui, China from 2007 to 2009 were included. The follow-up period ranged from 56 to 83 months. During the follow-up, the Lysholm knee score and Tegner activity score were used to assess knee function. The KT-2000 arthrometer (MEDmetric Corp., San Diego, CA, USA) was used to assess the stability of the reconstructed PCL. Results The mean Lysholm score, mean Tegner score, and mean forward and backward displacements were not significantly different between the final follow-up and 1 year after the surgery. Additionally, no significant differences were observed in any of the above-mentioned parameters between autologous and allogeneic reconstruction at the final follow-up. Conclusion Both autologous and allogeneic reconstruction had few complications and satisfactory long-term outcomes.

scholarly journals Arthroscopic Standard Anterior and Posteromedial Portal Posterior Cruciate Ligament Reconstruction With Remnant Preservation : 2-Year Follow-up

2020 ◽  
Vol 8 (B) ◽  
pp. 418-422
Author(s):  
Sholahuddin Rhatomy ◽  
Erwin Saspraditya ◽  
Riky Setyawan
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Pcl Reconstruction ◽  
Remnant Preservation ◽  
Lysholm Knee Score ◽  
Ikdc Score ◽  
Grade 3 ◽  
Pcl Injury

BACKGROUND: Grade 3 posterior cruciate ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of preservation of PCL remnant with achieve good visualization. AIM: The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-year follow-up. METHODS: We conducted a cohort retrospective study between January 2013 and December 2015. In this study, 25 patients underwent PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm Knee Score, Modified Cincinnati Score, and knee society score (KSS) at pre-operative and 2-year post-operative. Range of motion (ROM) and complications were evaluated postoperatively. RESULTS: The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p < 0.05). The average of Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The IKDC score improved from 60.50 ± 15.10 to 95.60 ± 3.44. Modified Cincinnati score improved from 62. 28 ± 13.6 to 96.04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. Twenty-two patients had 0–135° full ROM and three patients had 0–110° ROM. Two patients had surgical site infection but recovered with local debridement. CONCLUSION: PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation at 2-year follow-up resulted in satisfactory clinical and functional outcomes.

scholarly journals Arthroscopic Standard Anterior and Posteromedial Portal Posterior Cruciate Ligament Reconstruction With Remnant Preservation: 2-Year Follow-up

2019 ◽  
Vol 12 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Sholahuddin Rhatomy ◽  
Erwin Saspraditya ◽  
Riky Setyawan
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Pcl Reconstruction ◽  
Remnant Preservation ◽  
Lysholm Knee Score ◽  
Ikdc Score ◽  
Grade 3 ◽  
Pcl Injury

Background: Grade 3 Posterior Cruciate Ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of the preservation of PCL remnant with achieving good visualization. The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-years follow-up. Methods: We conducted a cohort retrospective study between January 2013 to December 2015. In this study, 25 patients underwent PCL reconstruction using standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm knee score, Modified Cincinnati Score, and Knee Society Score (KSS) at pre-operative and 2-years post-operative. Range of Motion (ROM) and complication were evaluated post-operatively. Results: The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p<0.05). The average Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The International Knee Documentation Committee (IKDC) score improved from 60.50 ± 15.10 to 95.60 ± 3.44. The Modified Cincinnati Score improved from 62. 28 ± 13.6 to 96,04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. 22 patients had 0-135° full ROM and 3 patients had 0-110° ROM. Two patients had surgical site infection but recovered with local debridement. Conclusion: PCL reconstruction using standard anterior and posteromedial portal with remnant preservation at 2 years follow up resulted in satisfactory clinical and functional outcomes.

Tibial Slope Strongly Influences Knee Stability After Posterior Cruciate Ligament Reconstruction: A Prospective 5- to 15-Year Follow-up

2016 ◽  
Vol 45 (2) ◽  
pp. 355-361 ◽  
Author(s):  
Clemens Gwinner ◽  
Andreas Weiler ◽  
Manoussos Roider ◽  
Frederik M. Schaefer ◽  
Tobias M. Jung
Keyword(s):  
Posterior Cruciate Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Posterolateral Corner ◽  
Knee Stability ◽  
Pcl Reconstruction ◽  
The Mean ◽  
Tibial Translation

Background: The reported failure rate after posterior cruciate ligament (PCL) reconstruction remains high. Previous studies have shown that the tibial slope (TS) influences sagittal plane laxity. Consequently, alterations of TS might have an effect on postoperative knee stability after PCL reconstruction. Hypothesis: We hypothesized that flattening of TS is associated with increased posterior laxity after PCL reconstruction. Study Design: Cohort study; Level of evidence 3. Methods: This study consisted of 48 patients who underwent PCL reconstruction in a single-surgeon series. Eight patients underwent an isolated PCL reconstruction, 27 patients underwent an additional posterolateral corner reconstruction, and 13 patients underwent a combined reconstruction of the PCL, anterior cruciate ligament, and posterolateral corner. Three blinded observers measured TS and the side-to-side difference (SSD) of posterior tibial translation (PTT) before and after PCL reconstruction using standardized stress radiographs. The minimum follow-up was 5 years. Results: At a mean follow-up of 103 months (range, 65-187), the mean SSD of PTT was significantly reduced (10.9 ± 2.9 vs 4.9 ± 4.3 mm; P < .0001). The mean TS was 8.0° ± 3.7° (range, 1°-14.3°) for the operated knee and 7.9° ± 3.2° (range, 2°-15.3°) for the contralateral knee. There was a statistically significant correlation between TS and PTT ( r = −0.77 and R2 = 0.59; P < .0001). In addition, there was a significant correlation between TS and the postoperative reduction of PTT ( r = 0.74 and R2 = 0.55; P < .0001). Subgrouping according to the number of operated ligaments showed no significant differences regarding TS or the mean reduction of PTT. Conclusion: Flattening of TS is associated with a significantly higher remaining PTT as well as a lower reduction of PTT. Notably, these results are irrespective of sex and number of ligaments addressed. Thus, isolated soft tissue procedures in PCL deficiency may only incompletely address posterior knee instability in patients with flattening of the posterior slope.

scholarly journals Clinical outcome of arthroscopic management of isolated posterior cruciate ligament injuries

2016 ◽  
Vol 2 (4) ◽  
pp. 411
Author(s):  
Suresh Perumal ◽  
Sadem Amer ◽  
Prakash Ayyadurai ◽  
Arumugam Sivaraman
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Hamstring Tendon ◽  
Lysholm Score ◽  
Radiographic Evaluation ◽  
Pcl Reconstruction ◽  
Avulsion Fractures ◽  
Arthroscopic Management

<p class="abstract"><strong>Background:</strong> Isolated posterior cruciate ligament<strong> (</strong>PCL) injuries are considered as benign and treated conservatively. But studies have shown the long term outcomes of these patients are poor. Aim of this study is to determine the functional outcomes, efficacy, and complication of isolated PCL injuries treated by arthroscopic PCL reconstruction or fixation.</p><p class="abstract"><strong>Methods:</strong> 24 patients, each with an isolated PCL injury, (17 with complete PCL tear and 7 with PCL avulsion fracture) were enrolled in this prospective study. Patients with complete tear underwent PCL reconstruction with hamstring tendon autograft and patients with displaced avulsion fractures underwent arthroscopic fixation with suture bridge technique. Average age at time of surgery was 33 years. Average time from injury to surgery was 1 month. Average follow-up period was 18 months. Patients underwent regular follow-up postoperatively with clinical and radiographic evaluation. Follow-up examinations comprised the Lysholm knee score, the International Knee Documentation Committee (IKDC) score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean preoperative Lysholm score for 24 knees was 41; mean postoperative Lysholm score was 90. Eighteen of 24 patients had excellent results, and 4 patients had good results and 2 patients have fare result at final assessment. IKDC ratings showed significant improvements on subsequent follow ups. In final IKDC ratings, 21 patients were assessed as normal or near normal (grade A or B).</p><p class="abstract"><strong>Conclusions:</strong> The short-term follow-up, analytical results showed good function after arthroscopic management in isolated PCL injuries. Hence we recommend surgical intervention in isolated PCL injuries.</p>

scholarly journals Review and Long-Term Outcomes of Cruciate Ligament Reconstruction versus Conservative Treatment in Siblings with Congenital Anterior Cruciate Ligament Aplasia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Diego Davanzo ◽  
Paolo Fornaciari ◽  
Geoffroy Barbier ◽  
Mauro Maniglio ◽  
Daniel Petek
Keyword(s):  
Anterior Cruciate Ligament ◽  
Conservative Treatment ◽  
Cruciate Ligament ◽  
Patient Counseling ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anterior Cruciate

There is no consensus on the best treatment for anterior cruciate ligament hypoplasia or aplasia. To our knowledge, no comparative study between operative and conservative treatment of this condition has ever been performed. Conservative treatment is a viable alternative to surgery for ACL aplasia. Two siblings were examined at our outpatient clinic. The male patient underwent bilateral ACL reconstruction, while his sister was treated conservatively. Our results show a worse long-term outcome for the operative patient. At her last follow-up, the female patient treated conservatively showed subjective improvement in stability and gait. A review of the literature shows inconsistent outcomes after reconstruction in contrast to reports with cruciate ligament agenesis that did not undergo reconstruction with acceptable to good outcomes. Cruciate reconstruction should be reserved for cases of impaired articular instability, objectively manifest in the frequency of giving-way episodes. Treatment depends on the patient’s condition and expectations. Surgery should therefore only be suggested after proper patient counseling.

Sign in / Sign up

Export Citation Format

Share Document