scholarly journals Loading Patterns of the Posterior Cruciate Ligament in the Healthy Knee: A Systematic Review

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0167106 ◽  
Author(s):  
S. H. Hosseini Nasab ◽  
Renate List ◽  
Katja Oberhofer ◽  
Sandro F. Fucentese ◽  
Jess G. Snedeker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Loading Patterns ◽  
Healthy Knee

scholarly journals Outcomes of Pediatric Posterior Cruciate Ligament Reconstruction: A Systematic Review

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110325
Author(s):  
Michael J. Scarcella ◽  
Sercan Yalcin ◽  
Nicholas R. Scarcella ◽  
Paul Saluan ◽  
Lutul D. Farrow
Keyword(s):  
Systematic Review ◽  
Posterior Cruciate Ligament ◽  
Patient Reported Outcomes ◽  
Pediatric Patients ◽  
Cruciate Ligament ◽  
Small Sample ◽  
Common Mechanism ◽  
Good Patient ◽  
Patient Reported ◽  
Return To Activity

Background: Little has been reported in the literature regarding surgical treatment of posterior cruciate ligament (PCL) injuries in pediatric patients. Purpose/Hypothesis: The purpose was to evaluate presentation, injury pattern, outcomes, and complications of surgically managed PCL injuries in pediatric patients. It was hypothesized that pediatric patients would have good patient-reported outcomes and no significant radiographic changes or complications. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed using PubMed, Medline, EMBASE, Scopus, and Cochrane databases between 1975 and December 16, 2019. Search terms included “posterior cruciate ligament,” “peel-off injury,” “avulsion,” “PCL,” “pediatric,” “skeletally immature,” and “adolescent.” Included were studies on pediatric patients with PCL injuries managed operatively. Exclusion criteria included case reports, studies not reporting clinical results, reviews, abstract or conference papers, or papers not in the English language. Quality assessment was performed on all included studies using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Results: Four articles comprising 43 knees in 42 patients met the criteria and were included. Motor vehicle accidents were the most common mechanism of injury (39.5%; n = 17/43), followed by sports-related injuries (35%; n = 15/43). All studies commented on tear pattern, with the following distribution: 42% (n = 18/43) midsubstance tears, 37% (n = 16/43) tibial avulsions, and 21% (n = 9/43) femoral avulsions. Overall, good patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score and Pediatric International Knee Documentation Committee, Tegner, and Lysholm scores) and return to activity, as well as satisfactory posterior stability (KT-1000 arthrometer, posterior drawer test, and kneeling radiographs) and range of motion, were reported. There was no significant leg-length discrepancy or angular deformity reported. Arthrofibrosis was reported in 7% of postoperative knees and was the most commonly reported complication. Osteoarthritis was reported in 21% (n = 9/43) of knees. The average MINORS score was 7 (range, 6-8) for noncomparative studies and 10 for comparative studies. Conclusion: Good patient-reported outcomes and return to activity can be obtained using repair or reconstruction. This evidence was limited by the quality of the included studies and overall small sample size; however, this review serves as a baseline for futures studies on PCL repair/reconstruction in pediatric patients.

scholarly journals Mathematic Modelling of Stress in Healthy Knee Joint and After Arthroplastywith Different Typesof Endoprostheses

2017 ◽  
pp. 11-16
Author(s):  
S. M. Smetanin ◽  
G. M. Kavalerskiy
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Mathematical Modelling ◽  
Mathematical Models ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Healthy Knee ◽  
Deformed State

Purpose of study. To study stressed-deformed state of the healthy knee joint and after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament by the method of numerical mathematical modelling.Materials and methods.Peculiarities of stress distribution in bones were determined on three mathematical models - healthy knee joint and joint after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament at the set load (80 kg) in straightened leg and either 45° or 90° knee flexion.Results. In healthy knee joint with a straightened leg the stress in the tibia is 2.3 times higher than in the femur. With knee flexion the stress in bone tissue increases and this increase is more intensive in the femur. After arthroplasty using endoprosthesis with substitution of the posterior cruciate ligament the stress in the tibia and femur is higher at all flexion angles as compared to arthroplasty using endoprosthesis with posterior cruciate ligament preservationConclusion.The obtained data may be used for mathematical substantiation of the advantage of endoprosthesis with preservation of the posterior cruciate ligament and in complex with the data of national and international registers will enable to optimize the treatment tactics in patients to whom knee arthroplasty is indicated.

Anatomy of the Femoral Footprint of the Posterior Cruciate Ligament: A Systematic Review

2015 ◽  
Vol 31 (2) ◽  
pp. 345-354 ◽  
Author(s):  
Steven J. Narvy ◽  
Matthew Pearl ◽  
Michael Vrla ◽  
Anthony Yi ◽  
George F. Rick Hatch
Keyword(s):  
Systematic Review ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament

Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

2017 ◽  
Vol 46 (3) ◽  
pp. 734-742 ◽  
Author(s):  
Perry O. Hooper ◽  
Chris Silko ◽  
Tennison L. Malcolm ◽  
Lutul D. Farrow
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Posterior Cruciate Ligament ◽  
English Language ◽  
Cruciate Ligament ◽  
Open Group ◽  
Treatment Modalities ◽  
Avulsion Fractures ◽  
Bony Avulsion ◽  
Patient Reported

Background: Tibial-sided avulsion injuries of the posterior cruciate ligament (PCL) generally require surgical intervention. No consensus exists concerning the optimal surgical treatment approach for these injuries. Purpose: To perform a systematic review investigating the open and arthroscopic surgical treatment modalities, outcomes, and complications of PCL tibial-sided bony avulsions. Study Design: Systematic review; Level of evidence, 4. Methods: The authors performed a systematic review of the literature utilizing PubMed and EMBASE from 1975 to present outlining open versus arthroscopic surgical repair of PCL bony avulsion injuries and comparing subjective and objective postoperative patient-reported outcomes, including Tegner, IKDC (International Knee Documentation Committee), and Lysholm scoring systems, as well as rates of patient complications. The quest was performed in June 2016, and searched terms included posterior cruciate ligament, PCL, bony, avulsion(s), tibial-sided, open, and arthroscopic. Inclusion criteria included English-language studies involving surgical fixation strategies for PCL tibial-sided bony avulsions. Exclusion criteria included non-English language, case studies/case series, and subject matter not pertaining to PCL bony avulsions. Results: Twenty-eight articles comprising 637 patients met the criteria and were included in the final review. PCL injuries with a tibial-sided avulsion were the result of motor vehicle accidents in 68.4% of patients, with 59.0% of these injuries resulting from motorcycle accidents. The arthroscopic group had better IKDC grade A scores (78.9%), indicating a normal knee postoperatively, as compared with the open group (65.9%). The postoperative Lysholm scores were similar between the groups, with a mean of 95.0 in the arthroscopic group and 92.8 in the open group. The arthroscopic group also reported 100% return to preinjury level of activity, compared with 86.2% in the open group. The most common complication in both groups was arthrofibrosis, which was reported more often in the arthroscopic group (0%-35%) versus the open treatment group (0%-25%). Conclusion: In patients with displaced tibial-sided PCL avulsion fractures treated operatively, surgical approaches render similar outcomes and risks. While the arthroscopic group had somewhat higher subjective and objective knee outcome scores, it demonstrated a slightly higher rate of arthrofibrosis. The clear advantage of the arthroscopic approach is that concomitant intra-articular injuries seen on preoperative magnetic resonance imaging, such as meniscal tears or osteochondral loose fragments, can be addressed at the time of the index operation.

scholarly journals Does Posterior Cruciate Ligament Retention or Sacrifice in Total Knee Replacement Affect Proprioception? A Systematic Review

2021 ◽  
Vol 10 (16) ◽  
pp. 3470
Author(s):  
Marco Bravi ◽  
Fabio Santacaterina ◽  
Federica Bressi ◽  
Rocco Papalia ◽  
Stefano Campi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Replacement ◽  
Posterior Cruciate Ligament ◽  
Knee Replacement ◽  
Cruciate Ligament ◽  
Assessment Method ◽  
Human Motion ◽  
Current Evidence ◽  
Future Research ◽  
Total Knee

Background: Proprioception is an important part of the somatosensory system involved in human motion control, which is fundamental for activities of daily living, exercise, and sport-specific gestures. When total knee arthroplasty (TKA) is performed, the posterior cruciate ligament (PCL) can be retained, replaced, or discarded. The PCL seems to be responsible for maintaining the integrity of the joint position sense (JPS) and joint kinesthesia. The aim of this review was to assess the effect of PCL on knee joint proprioception in total knee replacement. Methods: This systematic review was conducted within five electronic databases: PubMed, Scopus, Web of Science, Cochrane, and PEDro with no data limit from inception to May 2021. Results: In total 10 publications were evaluated. The analysis was divided by proprioception assessment method: direct assessment (JPS, kinesthesia) and indirect assessment (balance). Conclusions: The current evidence suggest that the retention of the PCL does not substantially improve the joint proprioception after TKA. Due to the high heterogeneity of the studies in terms of design, proprioception outcomes, evaluation methods, further studies are needed to confirm the conclusions. In addition, future research should focus on the possible correlation between joint proprioception and walking function.

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