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Posterior cruciate ligament

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https://www.readbyqxmd.com/read/28437856/microstructure-variations-in-the-soft-hard-tissue-junction-of-the-human-anterior-cruciate-ligament
#1
Lei Zhao, Peter V Lee, David C Ackland, Neil D Broom, Ashvin Thambyah
The role of the sub-bundles in the anterior cruciate ligament (ACL) has been defined, such that the anterior-medial bundle directly resists anterior tibial translation while the posterior lateral bundle is involved in rotational stability. With regards to this biomechanical function, much of the previous work on bundle-specific morphology has been carried out on the macro-scale, with much less attention given to the micro-to-ultrastructural scalar levels. This is especially true of the enthesis and its microstructure, a biomechanically significant region that has been largely neglected in the published literature dealing with ACL sub-bundle anatomy...
April 24, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28437619/management-of-posterior-cruciate-ligament-tibial-avulsion-injuries-a-systematic-review
#2
Perry O Hooper, Chris Silko, Tennison L Malcolm, Lutul D Farrow
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...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28433391/mechanisms-of-anterior-posterior-stability-of-the-knee-joint-under-load-bearing
#3
Ryan J Reynolds, Peter S Walker, John Buza
The anterior-posterior (AP) stability of the knee is an important aspect of functional performance. Studies have shown that the stability increases when compressive loads are applied, as indicated by reduced laxity, but the mechanism has not been fully explained. A test rig was designed which applied combinations of AP shear and compressive forces, and measured the AP displacements relative to the neutral position. Five knees were evaluated at compressive loads of 0, 250, 500, and 750N, with the knee at 15° flexion...
April 7, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28430526/the-bow-tie-shape-of-the-anterior-cruciate-ligament-as-visualized-by-high-resolution-magnetic-resonance-imaging
#4
Kang Min Sohn, Min Jin Lee, Helen Hong, Young Cheol Yoon, Chan Deok Park, Joon Ho Wang
BACKGROUND: Although numerous studies have examined the anatomic characteristics of the anterior cruciate ligament (ACL), its actual shape remains unclear. PURPOSE: To determine the average shape of the ACL by analyzing its cross section through the use of high-resolution magnetic resonance imaging (MRI) data. STUDY DESIGN: Descriptive laboratory study. METHODS: The study included 96 MRIs, conducted using a 3.0-T magnet, to analyze the shape of the ACL...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28425757/the-prevalence-and-characteristics-of-a-subcortical-cystic-lesion-at-the-subspinous-region-of-the-knee
#5
Ji Ye Son, Young Cheol Yoon, Wook Jin, Jang Gyu Cha
Background Although we observed that subcortical cysts near the attachment of the meniscus or cruciate ligaments are frequently seen with a tear or degeneration of the adjacent meniscus and/or cruciate ligament, there is no large study describing the prevalence, distribution, and associated findings of these cysts. Purpose To evaluate the prevalence and distribution of subcortical cysts near the attachments of the meniscus or cruciate ligaments and evaluate pathologies of the meniscus or cruciate ligaments using magnetic resonance imaging (MRI)...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28416088/a-novel-mis-technique-for-posterior-cruciate-ligament-avulsion-fractures
#6
Ashok S Gavaskar, Bhupesh Karthik, Hitesh Gopalan, Parthasarathy Srinivasan, Naveen C Tummala
OBJECTIVE: Open surgical approaches to treat tibial avulsion fractures of the posterior cruciate ligament (PCL) often use large incisions involving extensive muscle dissection and retraction. The objective of this study was to describe a new mini-invasive approach targeting the fractured zone, to minimize surgical dissection and improve recovery and rehabilitation. METHODS: The new approach was used in 15 males and seven females with isolated PCL avulsions. The length of the surgical incision, surgical time, need for conversion to open technique, visual analog scores (VAS) and duration of hospital stay were studied to assess the efficacy, learning curve and advantages of the new technique...
April 13, 2017: Knee
https://www.readbyqxmd.com/read/28409139/double-bundle-pcl-reconstruction-using-autologous-hamstring-tendons-outcome-with-a-minimum-2-year-follow-up
#7
Ricardo de Paula Leite Cury, Rômulo Neves Castro Filho, Daniel Akira Sadatsune, Davi Ribeiro do Prado, Ricardo José Peruzzo Gonçalves, Marcos Barbieri Mestriner
OBJECTIVE: To present the outcomes of posterior cruciate ligament (PCL) double-bundle reconstruction using autologous hamstring tendons, with a minimum follow-up of two years. METHODS: Evaluation of 16 cases of PCL injury that underwent double-bundle reconstruction with autogenous hamstring tendons, between 2011 and 2013. The final sample consisted of 16 patients, 15 men and one woman, with a mean age of 31 years (21-49). The predominant mechanism was motorcycle accident in half of the cases...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28409107/a-transosseous-bone-bridge-repair-for-posterior-horn-meniscal-root-tears-during-anterior-cruciate-ligament-reconstruction
#8
Jonathan M Frank, Daniel J Liechti, Jack Anavian, Thomas R Hackett
Meniscal root tears occur in isolation or concurrently with ligamentous knee injury and cause significantly altered knee mechanics with the loss of normal meniscus hoop stress. This loss of normal meniscus function can result in abnormal knee kinematics and, subsequently, more rapid degenerative changes of the knee articular surface. In the setting of anterior cruciate ligament tear, the posterolateral meniscus root is most commonly damaged. Several techniques exist for meniscus root repair; however, none have been shown to be clearly superior...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28409105/anatomic-single-bundle-anterior-cruciate-ligament-reconstruction-using-the-modified-transtibial-technique
#9
Dhong Won Lee, Jin Goo Kim
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with a modified transtibial technique. Our modified transtibial technique has the advantages of the conventional transtibial technique that is familiar to surgeons and that allows the press-fit fixing and enables us to make a relatively long femoral tunnel. To make the femoral tunnel at the anatomic position, the triangular, funnel-shaped bony trough was made to slip the eccentrically positioned guide pin into the anticipated anatomic center with a free-hand technique after marking the anatomic ACL footprint using a microfracture awl through the anteromedial portal...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28409103/posterior-cruciate-ligament-reconstruction-with-hamstring-tendons-using-a-suspensory-device-for-tibial-fixation-and-interference-screw-for-femoral-fixation
#10
Alejandro Espejo-Baena, Alejandro Espejo-Reina, María Josefa Espejo-Reina, Maximiano Lombardo-Torre
A technique for posterior cruciate ligament reconstruction is presented. Autologous hamstring tendons are selected as a graft. An interference screw is used for femoral fixation. A suspension device is used for tibial fixation to bring the fixation closer to the articular end of the tibial tunnel. Single diameter tunnels of the same diameter as the graft are created in an outside-in direction.
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28401277/stress-distribution-is-deviated-around-the-aperture-of-the-femoral-tunnel-in-the-anatomic-anterior-cruciate-ligament-reconstruction
#11
Yuichi Hoshino, Ryosuke Kuroda, Yuichiro Nishizawa, Naoki Nakano, Kanto Nagai, Daisuke Araki, Shinya Oka, Shogo Kawaguchi, Kouki Nagamune, Masahiro Kurosaka
PURPOSE: Final tunnel location in the anterior cruciate ligament (ACL) reconstruction is unpredictable due to tunnel widening and/or transposition. The mechanical stress around the tunnel aperture seems to be a major factor but is not fully investigated. The purpose of this study was to measure the stress from the ACL graft around the tunnel aperture when the ACL graft tension reaches its peak. METHODS: Six cadaveric knees were used. Single-bundle ACL reconstruction was performed using a hamstrings graft...
April 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28392051/evaluating-the-femoral-side-critical-corner-in-posterior-cruciate-ligament-reconstruction-the-effect-of-outside-in-versus-inside-out-creation-of-femoral-tunnels-on-graft-contact-pressure-in-a-synthetic-knee-model
#12
Steven J Narvy, George F Hatch, Hansel E Ihn, Nathanael D Heckmann, Michelle H McGarry, James E Tibone, Thay Q Lee
PURPOSE: To characterize and compare the graft contact characteristics of outside-in (OI) and inside-out (IO) femoral tunnels during single-bundle reconstruction of the anterolateral bundle of the posterior cruciate ligament in a synthetic knee model. METHODS: Femoral tunnels were separately made in 16 synthetic femora (8 OI and 8 IO). Achilles tendon allografts were fixed using suspensory fixation with a pressure sensor between the allograft and femoral tunnel...
April 6, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28389879/superior-long-term-survival-for-fixed-bearing-compared-with-mobile-bearing-in-ligament-balanced-total-knee-arthroplasty
#13
P J C Heesterbeek, A H van Houten, J S Klenk, H Eijer, B Christen, A B Wymenga, A J Schuster
PURPOSE: Only few long-term data on ligament-balanced cruciate-retaining total knee arthroplasty (CR TKA) are currently available. Either a mobile- or fixed-bearing insert can be chosen, which showed good mid-term outcome and few complications and revisions. This multi-centre retrospective cross-sectional cohort study investigated the 12-year results of primary TKA using a balancing gap technique and compared survival and clinical outcome between fixed and mobile inserts. METHODS: In this retrospective cross-sectional cohort study, 557 cases of three clinics (2 Swiss, 1 Dutch) operated between 1998 and 2003 with the first series of a TKA implanted with a balanced gap technique (433 (77...
April 7, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28378009/the-utility-of-bicruciate-retaining-total-knee-arthroplasty
#14
Feroz A Osmani, Savyasachi C Thakkar, Kristopher Collins, Ran Schwarzkopf
BACKGROUND: We describe the features of modern and historical bicruciate-retaining (BCR) total knee arthroplasty (TKA) implants compared with other TKA implant designs, reviewing kinematics, proprioception, operative technique, and clinical results. METHODS: We performed a review based on PubMed, Embase, CINAHL Plus, and Cochrane databases from January 1990 to April 2016 using combinations of the following keywords: "bicruciate-retaining arthroplasty," "bicruciate-retaining total knee arthroplasty," "bicruciate-retaining TKA," "kinematics," "knee kinematics," and "TKA kinematics...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28373949/arthroscopic-reduction-of-tibial-spine-avulsion-suture-lever-reduction-technique
#15
Joseph T Gamboa, Broc A Durrant, Neil P Pathare, Edward C Shin, James L Chen
Tibial spine avulsion fractures are uncommon knee injuries that predominantly occur in children and young adults. Restoration of anterior cruciate ligament length through surgical reduction and fixation of the fracture is necessary to ensure stability of the knee with suitable range of motion and minimal knee laxity. Arthroscopic repair of tibial spine avulsion fractures is a technically complex procedure, specifically when performing and maintaining the initial anatomic reduction. We describe in this technical note and accompanying video a unique 3-point fixation repair of tibial spine avulsion fractures using an arthroscopic assisted suture lever reduction technique...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28373934/remnant-preserving-posterior-cruciate-ligament-reconstruction-arthroscopic-transseptal-rod-and-pulley-technique
#16
Bancha Chernchujit, Supawat Samart, Pongtep Na Nakorn
The preservation of posterior cruciate ligament (PCL) remnant augmentation was recently proposed as a technique for PCL reconstruction. The technique achieved isometry and anatomic position of the PCL graft, but it was technically difficult. The present technique is a modified transseptal technique with visualization from both posteromedial and posterolateral portals. Moreover, this rod-pulley technique could prevent the killer turn effectively. The result was anatomic remnant augmented PCL graft.
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28370840/effect-of-femoral-tunnel-positions-on-graft-stress-in-outside-in-acl-reconstruction-surgery-during-continuous-knee-motion-a-simulation-study
#17
Kyungmin Kang, Tae Soo Bae
BACKGROUND: Previous studies regarding the optimal femoral tunnel location for an anterior cruciate ligament (ACL) reconstruction were based on static experiments at specific angles, and did not consider continuous motion of the knee. METHODS: Twenty-four surgical sites were set and continuous kinematic data, obtained from motion analysis, was used to describe knee movement. The bending angle and stress of the ACL graft as well as the length of the femoral tunnel was calculated through multi-flexible body dynamics analysis...
March 31, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28366539/influence-of-the-different-anteromedial-portal-on-femoral-tunnel-orientation-during-anatomic-acl-reconstruction
#18
Dong-Kyu Moon, Ho-Seung Jo, Dong-Yeong Lee, Dong-Geun Kang, June-Ho Byun, Sun-Chul Hwang
OBJECTIVE: The purpose of this study was to evaluate the effect of femoral tunnel orientation, drilled through the accessory anteromedial (AAM) portal or the high AM portal in anatomic anterior cruciate ligament (ACL) reconstruction. METHODS: In 16 cadaver knees, using o'clock method, centers of the ACL femoral footprint were drilled with an 8-mm reamer via an AAM portal (eight knees) or a high AM portal (eight knees). Computed tomography (CT) scans were taken of each knee...
March 30, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28361277/the-effect-of-a-dynamic-pcl-brace-on-patellofemoral-compartment-pressures-in-pcl-and-pcl-plc-deficient-knees
#19
Tyler Welch, Thomas Keller, Ruben Maldonado, Melodie Metzger, Karen Mohr, Ronald Kvitne
BACKGROUND: The natural history of posterior cruciate ligament (PCL) deficiency includes the development of arthrosis in the patellofemoral joint (PFJ). The purpose of this biomechanical study was to evaluate the hypothesis that dynamic bracing reduces PFJ pressures in PCL- and combined PCL/posterolateral corner (PLC)-deficient knees. STUDY DESIGN: Controlled Laboratory Study. METHODS: Eight fresh frozen cadaveric knees with intact cruciate and collateral ligaments were included...
December 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/28355671/multiligamentous-injury-of-the-knee-mri-diagnosis-and-injury-patterns
#20
Barry Glenn Hansford, Corrie M Yablon
Anterior cruciate and posterior cruciate injuries rarely occur in isolation and are often associated with injuries to the secondary or supporting structures that provide stability against rotational forces. These structures include the posterolateral and posteromedial corner ligaments and tendons, as well as the anterolateral ligament. If injuries to these secondary structures are not appreciated at the time of cruciate ligament reconstruction, an isolated cruciate ligament reconstruction may be predisposed to early failure...
April 2017: Seminars in Musculoskeletal Radiology
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