Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament. Report of a new procedure.

1983 ◽  
Vol 65 (3) ◽  
pp. 310-322 ◽  
Author(s):  
W G Clancy ◽  
K D Shelbourne ◽  
G B Zoellner ◽  
J S Keene ◽  
B Reider ◽  
...  
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Joint Instability ◽  
Cruciate Ligament

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.

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.

scholarly journals The MRI posterior drawer test to assess posterior cruciate ligament functionality and knee joint laxity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Marie Wollschläger ◽  
Karl Ludger Radke ◽  
Justus Schock ◽  
Niklas Kotowski ◽  
David Latz ◽  
...  
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Joint Laxity ◽  
Knee Joints ◽  
Joint Models ◽  
Human Knee ◽  
Clinical Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Therapeutic Decision Making

AbstractClinical Magnetic Resonance Imaging (MRI) of joints is limited to mere morphologic evaluation and fails to directly visualize joint or ligament function. In this controlled laboratory study, we show that knee joint functionality may be quantified in situ and as a function of graded posterior cruciate ligament (PCL)-deficiency by combining MRI and standardized loading. 11 human knee joints underwent MRI under standardized posterior loading in the unloaded and loaded (147 N) configurations and in the intact, partially, and completely PCL-injured conditions. For each specimen, configuration, and condition, 3D joint models were implemented to analyse joint kinematics based on 3D Euclidean vectors and their projections on the Cartesian planes. Manual 2D measurements served as reference. With increasing PCL deficiency, vector projections increased significantly in the anteroposterior dimension under loading and manual measurements demonstrated similar patterns of change. Consequently, if combined with advanced image post-processing, stress MRI is a powerful diagnostic adjunct to evaluate ligament functionality and joint laxity in multiple dimensions and may have a role in differentiating PCL injury patterns, therapeutic decision-making, and treatment monitoring.

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.

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