scholarly journals Kneeling stress knee x-rays - posterior cruciate ligament deficiency

2021 ◽  
Author(s):  
Henry Knipe
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
X Rays

Anatomy and Biomechanics of the Posterior Cruciate Ligament

2021 ◽  
Vol 34 (05) ◽  
pp. 499-508
Author(s):  
Thomas B. Lynch ◽  
Jorge Chahla ◽  
Clayton W. Nuelle
Keyword(s):  
Posterior Cruciate Ligament ◽  
Clinical Decision Making ◽  
Cruciate Ligament ◽  
Primary Role ◽  
X Rays ◽  
Posterior Tibial Translation ◽  
Posterior Tibial ◽  
Knee Pathology ◽  
Tibial Translation

AbstractPosterior cruciate ligament (PCL) injuries are often encountered in the setting of other knee pathology and sometimes in isolation. A thorough understanding of the native PCL anatomy is crucial in the successful treatment of these injuries. The PCL consists of two independent bundles that function in a codominant relationship to perform the primary role of resisting posterior tibial translation relative to the femur. A secondary role of the PCL is to provide rotatory stability. The anterolateral (AL) bundle has a more vertical orientation when compared with the posteromedial (PM) bundle. The AL bundle has a more anterior origin than the PM bundle on the lateral wall of the medial femoral condyle. The tibial insertion of AL bundle on the PCL facet is medial and anterior to the PM bundle. The AL and PM bundles are 12-mm apart at the center of the femoral origins, while the tibial insertions are more tightly grouped. The different spatial orientation of the two bundles and large distance between the femoral centers is responsible for the codominance of the PCL bundles. The AL bundle is the dominant restraint to posterior tibial translation throughout midrange flexion, while the PM bundle is the primary restraint in extension and deep flexion. Biomechanical testing has shown independent reconstruction of the two bundles that better reproduces native knee biomechanics, while significant differences in clinical outcomes remain to be seen. Stress X-rays may play an important role in clinical decision-making process for operative versus nonoperative management of isolated PCL injuries. Strong understanding of PCL anatomy and biomechanics can aid surgical management.

scholarly journals Posteromedial versus direct posterior approach for posterior cruciate ligament avulsion – A comparative study

2020 ◽  
Vol 27 (2) ◽  
pp. 166-172
Author(s):  
Jatin Prakash ◽  
Ashish Jaiman ◽  
Rajesh Kumar Chopra
Keyword(s):  
Blood Loss ◽  
Posterior Cruciate Ligament ◽  
Posterior Approach ◽  
Cruciate Ligament ◽  
Screw Placement ◽  
Primary Study ◽  
X Rays ◽  
Study Objective ◽  
Posterior Group ◽  
Functional Scores

Background/Purpose: Open reduction of acute avulsion of posterior cruciate ligament (PCL) fragment may be achieved through direct posterior approach or posteromedial approach. The aim of our study was to compare these two techniques for fixation of avulsed PCL fragment. Our primary study objective was to study that which of the above techniques provides a better screw placement on post-operative radiographs. The secondary objectives were to study any statistically significant differences in surgical time, blood loss, incidence of neurovascular injury, bone union and functional knee scores in the above two techniques. Materials and methods: This is a prospective, comparative, interventional, single tertiary referral centre-based study from November 2014 to May 2019. Patients in the direct posterior group were treated with the approach described by Abbott and Carpenter, and patients in the posteromedial group were treated with the approach described by Burks and Schaffer. Screw placement was assessed on anteroposterior (AP) and lateral knee X-rays. Blood loss was studied using haemoglobin balance method. Functional scores were recorded preoperatively and at 1-year follow up using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee scores. Results: The posterior group showed better screw placement angle compared to the posteromedial group. In the AP plane, the mean angle of screw placement and fracture line was 83° compared to 59° in the posteromedial group. Average fracture union time, post-operative range of motion and post-operative WOMAC scores were not statistically different in both groups. There were no cases of neurovascular complication, deep vein thrombosis and superficial or deep surgical site infection in any group. Conclusion: Direct posterior approach to PCL avulsion provides better screw placement angle compared to the posteromedial approach, which might result in better interfragmentary compression at the avulsion site. However, the two approaches did not differ statistically in terms of functional scores of patients reported at 1 year.

Isolated Posterior Cruciate Ligament Injuries

1994 ◽  
Vol 13 (3) ◽  
pp. 519-530 ◽  
Author(s):  
James R. Andrews ◽  
John C. Edwards ◽  
Yvonne E. Satterwhite
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Ligament Injuries

scholarly journals Open knee dislocation with a patellar tendon rupture: Result of staged surgical repair

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882310
Author(s):  
Tsuneari Takahashi ◽  
Tomohiro Matsumura ◽  
Kazuaki Ishihara ◽  
Shuhei Hiyama ◽  
Katsushi Takeshita
Keyword(s):  
Posterior Cruciate Ligament ◽  
Surgical Management ◽  
Patellar Tendon ◽  
Tendon Rupture ◽  
Cruciate Ligament ◽  
Knee Dislocation ◽  
Patellar Tendon Rupture ◽  
Collateral Ligament ◽  
Range Of Movement ◽  
Multiligament Injury

Knee dislocation with concomitant multiligament injury is a rare and devastating injury. We report the successful repair of a rare case of open knee dislocation with concomitant multiligament injury and patellar tendon rupture of an 18-year-old male due to a motorcycle accident. The patient presented with an open wound running parallel to the knee joint line and patellar tendon rupture with full exposure of the cartilage of the distal femur. Staged surgical management including the application of a ring-type external fixator with a hinged joint, lateral collateral ligament repair, medial collateral ligament reconstruction using autogenous hamstring tendon, and joint release was performed. Range of movement was recovered to 0 degrees of knee extension and 80 degrees of knee flexion, and extension lag was negative. The Lysholm score of the patient was recovered to 92. The patient was able to return to work in the construction field 2 years after sustaining the injury. The patient had no complaint of pain and was able to resume construction work, even though reconstruction of the anterior cruciate ligament and posterior cruciate ligament was not performed. The application of a hinged ring-type external fixation device might play a key role in early range of movement restoration and to maintain the reduced position and acceptable recovery of the posterior cruciate ligament injury without the need for reconstructive surgery. This report is the first to describe the safety and effectiveness of staged surgical management for the repair of open knee dislocation with concomitant multiligament injury and patellar tendon rupture. However, further studies with longer follow-up periods will be needed to observe the development of osteoarthritis or weakness of the knee. Staged surgical management is a safe and effective procedure for repairing an open knee dislocation with concomitant multiligament injury and patellar tendon rupture.

Sign in / Sign up

Export Citation Format

Share Document