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Posterior cruciate ligament

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https://www.readbyqxmd.com/read/27909681/double-bundle-all-inside-posterior-cruciate-ligament-reconstruction-a-technique-using-2%C3%A2-separate-autologous-grafts
#1
Roy A G Hoogeslag, Bart W Oudelaar, Rianne Huis In't Veld, Reinoud W Brouwer
In a double-bundle posterior cruciate ligament reconstruction, several surgical techniques are available. Compared with other techniques, the advantages of the all-inside technique and cortical suspension devices with variable loop length are that shorter grafts can be used, tendons can be quadrupled, and a double-bundle posterior cruciate ligament reconstruction can be performed with autologous grafts. Furthermore, the all-inside technique provides independent outside-in socket reaming and is soft tissue, cortex, and bone sparing because no full diameter tunnels but sockets are created with a small diameter guide pin, which can transform into a retrograde drill...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904597/where-does-magnetic-resonance-imaging-stand-in-the-diagnosis-of-knee-injuries
#2
Shirvan Rastegar, Mahdi Motififard, Amin Nemati, Naeime-Sadat Hosseini, Mohammad Ali Tahririan, Sayyed Alireza Rozati, Mahdi Sepiani, Mehdi Moezi
BACKGROUND: The aim of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) in the diagnosis of knee injuries. MATERIALS AND METHODS: Ninety-eight consecutive patients were enrolled in the study. In all patients, MRI and arthroscopy were performed and the results were compared. RESULTS: MRI was most sensitive in the detection of medial meniscus injuries, and the highest specificity and negative predictive value (NPV) were found in the detection of posterior cruciate ligament injuries...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904222/functional-and-computed-tomography-correlation-of-femoral-and-tibial-tunnels-in-single-bundle-anterior-cruciate-ligament-reconstruction-use-of-accessory-anteromedial-portal
#3
Naveen Joseph Mathai, Rajkumar S Amaravathi, K V Pavan, Padmanabhan Sekaran, Gaurav Sharma, Belliappa Codanda
BACKGROUND: An accessory anteromedial portal (AAMP) has been shown to be effective in placing an anatomically ideal femoral tunnel. It is well known that this is due to the independent femoral drilling which is possible with the AAMP. However very little is known regarding the significance of this reconstruction technique in influencing the functional outcomes of anatomic anterior cruciate ligament reconstruction (ACLR). This study documents the influence of tibial and femoral tunnel positions on functional outcomes of anatomic ACLR using the AAMP...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27904024/cartilage-attachment-morphology-of-the-fetal-cruciate-ligaments-of-the-knee-an-immunohistochemical-study-using-human-fetal-specimens
#4
Masahito Yamamoto, Hiromasa Takada, Takeshi Takayama, Sakura Katsumura, Mayumi Sato, Hiroshi Abe, Gen Murakami, Shin-Ichi Abe
Fetal cruciate ligaments of the knee provide two types of cartilage attachments: to a cartilage fovea or a simple continuation to the perichondrium. To examine a difference in matrix substance between a ligament attachment to the fovea and another attachment to the perichondrium. We histologically observed 12 human fetal femurs in which the posterior (or anterior) cruciate ligament provided a fovea-type (or a perichondrium-type) attachment. Immunohistochemistry of matric substances (aggrecan, versican, tenascin-c) was performed...
2016: Okajimas Folia Anatomica Japonica
https://www.readbyqxmd.com/read/27899355/the-anatomic-centers-of-the-femoral-and-tibial-insertions-of-the-anterior-cruciate-ligament-a-systematic-review-of-imaging-and-cadaveric-studies-reporting-normal-center-locations
#5
Anagha P Parkar, Miraude E A P M Adriaensen, Søren Vindfeld, Eirik Solheim
BACKGROUND: The anterior cruciate ligament (ACL) is regularly reconstructed if knee joint function is impaired. Anatomic graft tunnel placement, often assessed with varying measurement methods, in the femur and tibia is considered important for an optimal clinical outcome. A consensus on the exact location of the femoral and tibial footprint centers is lacking. PURPOSE: To systematically review the literature regarding anatomic centers of the femoral and tibial ACL footprints and assess the mean, median, and percentiles of normal centers...
November 29, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27896678/no-clinically-important-difference-in-knee-scores-or-instability-between-transtibial-and-inlay-techniques-for-pcl-reconstruction-a-systematic-review
#6
REVIEW
Young-Soo Shin, Hyun-Jung Kim, Dae-Hee Lee
BACKGROUND: It is unclear whether the biomechanical superiority of the inlay technique over the transtibial technique, arising from avoidance of the killer turn at the graft-tunnel margin of the proximal tibia during posterior cruciate ligament (PCL) reconstruction, leads to better knee scores or greater knee stability. QUESTIONS/PURPOSES: This systematic review was designed to compare Tegner and Lysholm scores, and posterior residual laxity of the knee, between single-bundle PCL reconstruction using transtibial and inlay techniques...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27881382/early-changes-in-knee-center-of-rotation-during-walking-after-anterior-cruciate-ligament-reconstruction-correlate-with-later-changes-in-patient-reported-outcomes
#7
Matthew R Titchenal, Constance R Chu, Jennifer C Erhart-Hledik, Thomas P Andriacchi
BACKGROUND: Altered knee kinematics after anterior cruciate ligament injury and reconstruction (ACLR) have been implicated in the development of posttraumatic osteoarthritis (PTOA), leading to poor long-term clinical outcomes. PURPOSE: This study was conducted to determine (1) whether the average knee center of rotation (KCOR), a multidimensional metric of knee kinematics, of the ACL-reconstructed knee during walking differs from that of the uninjured contralateral knee; (2) whether KCOR changes between 2 and 4 years after surgery; and (3) whether early KCOR changes predict patient-reported outcomes 8 years after ACLR...
November 23, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27880849/loading-patterns-of-the-posterior-cruciate-ligament-in-the-healthy-knee-a-systematic-review
#8
S H Hosseini Nasab, Renate List, Katja Oberhofer, Sandro F Fucentese, Jess G Snedeker, William R Taylor
BACKGROUND: The posterior cruciate ligament (PCL) is the strongest ligament of the knee, serving as one of the major passive stabilizers of the tibio-femoral joint. However, despite a number of experimental and modelling approaches to understand the kinematics and kinetics of the ligament, the normal loading conditions of the PCL and its functional bundles are still controversially discussed. OBJECTIVES: This study aimed to generate science-based evidence for understanding the functional loading of the PCL, including the anterolateral and posteromedial bundles, in the healthy knee joint through systematic review and statistical analysis of the literature...
2016: PloS One
https://www.readbyqxmd.com/read/27872126/multiple-ligament-reconstruction-femoral-tunnels-intertunnel-relationships-and-guidelines-to-avoid-convergence
#9
Gilbert Moatshe, Alex W Brady, Erik L Slette, Jorge Chahla, Travis Lee Turnbull, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations often require multiple concurrent ligament reconstructions, which involve creating several tunnels in the distal femur. Therefore, the risk of tunnel convergence is increased because of the limited bone volume within the distal aspect of the femur. PURPOSE: To assess the risk of tunnel convergence and determine the optimal reconstruction tunnel orientations for multiple ligament reconstructions in the femur. STUDY DESIGN: Descriptive laboratory study...
November 21, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27868076/synovial-c-shaped-tibial-footprint-of-the-anterior-cruciate-ligament
#10
César Janovsky, Camila Cohen Kaleka, Maria Teresa Seixas Alves, Mario Ferretti, Moises Cohen
BACKGROUND: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. PURPOSE: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. STUDY DESIGN: Descriptive laboratory study...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27859544/lateral-soft-tissue-structures-contribute-to-cruciate-retaining-total-knee-arthroplasty-stability
#11
Kiron K Athwal, Hadi El Daou, Breck Lord, Andrew J Davies, William Manning, Ferdinando Rodriguez Y Baena, David J Deehan, Andrew A Amis
Little information is available to surgeons regarding how the lateral structures prevent instability in the replaced knee. The aim of this study was to quantify the lateral soft-tissue contributions to stability following cruciate-retaining total knee arthroplasty (CR TKA). Nine cadaveric knees were tested in a robotic system at full extension, 30°, 60°, and 90° flexion angles. In both native and CR implanted states, ±90 N anterior-posterior force, ±8 Nm varus-valgus, and ±5 Nm internal-external torque were applied...
November 9, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27856067/posterior-cruciate-ligament-retention-or-substitution-during-total-knee-arthroplasty-does-not-affect-long-term-bone-mineral-density-or-quality
#12
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Koji Todoroki, Shin-Ichi Toyabe
BACKGROUND: Physical activity is recognized as one of the factors that influence bone mineral density (BMD) and bone quality after total knee arthroplasty (TKA). According to biomechanical analyses after posterior cruciate ligament (PCL) retaining (PCLR) and substituting (PCLS) TKA, each implant design has different kinematics and kinetics. The purposes of this study were: (1) to perform within-patient comparisons of the midterm and long-term effects of PCL retention in mobile-bearing TKA on proximal femur and tibia BMD and calcaneus bone quality measured using ultrasound and (2) to identify correlations between them...
October 26, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27855310/between-leg-differences-in-challenging-single-limb-balance-performance-one-year-following-anterior-cruciate-ligament-reconstruction
#13
Anna L Hatton, Kay M Crossley, Ross A Clark, Timothy S Whitehead, Hayden G Morris, Adam G Culvenor
Following anterior cruciate ligament (ACL) rupture, reconstructive surgery (ALCR) is often performed to mechanically stabilise the knee, however functional deficits often persist long after surgery. Impaired single-limb standing balance has been observed in the ACLR limb compared to healthy individuals. However, it remains inconclusive as to whether these same balance deficits exist between the injured and contralateral uninjured limbs, during challenging balance tasks, and at a time when patients are permitted to return to sport...
November 11, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27847856/arthroscopic-bridge-technique-for-pcl-avulsion-surgical-technique-and-key-points
#14
Seyed Taghi Nourbakhsh, Fateme Bahramian, Zohreh Zafarani, Ardeshir Alidousti, Hamidreza Aslani
This study describes all-arthroscopic fixation of the posterior cruciate ligament avulsion fracture using 'suture bridge technique'. We used this technique in 3 consecutive patients. All were satisfied and returned to the activities prior to injury. This technique can be considered as a safe and effective method for fixation of PCL avulsion, which allows active mobilization with lowered risk of complications.
October 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27847839/anatomical-individualized-acl-reconstruction
#15
REVIEW
Amir Ata Rahnemai-Azar, Soheil Sabzevari, Sebastián Irarrázaval, Tom Chao, Freddie H Fu
The anterior cruciate ligament (ACL) is composed of two bundles, which work together to provide both antero-posterior and rotatory stability of the knee. Understanding the anatomy and function of the ACL plays a key role in management of patients with ACL injury. Anatomic ACL reconstruction aims to restore the function of the native ACL. Femoral and tibial tunnels should be placed in their anatomical location accounting for both the native ACL insertion site and bony landmarks. One main component of anatomical individualized ACL reconstruction is customizing the treatment according to each patient's individual characteristics, considering preoperative and intraoperative evaluation of the native ACL and knee bony anatomy...
October 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27843343/the-danish-knee-ligament-reconstruction-registry
#16
REVIEW
Lene Rahr-Wagner, Martin Lind
The Danish Knee Ligament Reconstruction Registry was established in 2005 as a web-based nationwide clinical database with the purpose of improving the monitoring and quality of both primary and revision knee ligament reconstructions in Denmark. All primary and revision anterior and posterior cruciate ligament reconstructions as well as collateral ligament and multiligament reconstructions are recorded. Main variables include sex, age, cause of injury, objective ligament instability, and surgical data, such as affected ligament, graft- and implant choice, operation technique among other things...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27843134/effect-of-posterior-cruciate-ligament-rupture-on-biomechanical-and-histological-features-of-lateral-femoral-condyle
#17
Zhenhan Deng, Yusheng Li, Hong Liu, Kanghua Li, Guanghua Lei, Bangbao Lu
BACKGROUND The aim of this study was to investigate bone mineral density (BMD) and the biomechanical and histological effects of posterior cruciate ligament (PCL) rupture on the lateral femoral condyle. MATERIAL AND METHODS Strain on different parts of the lateral femoral condyle from specimens of normal adult knee joints, including 12 intact PCLs, 6 ruptures of the anterolateral bundle, 6 ruptures of the postmedial bundle, and 12 complete ruptures, was tested when loaded with different loads on the knee at various flexion angles...
November 15, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27837219/acl-substitution-may-improve-kinematics-of-pcl-retaining-total-knee-arthroplasty
#18
Thomas Zumbrunn, Michael P Duffy, Harry E Rubash, Henrik Malchau, Orhun K Muratoglu, Kartik Mangudi Varadarajan
PURPOSE: One of the key factors responsible for altered kinematics and joint stability following contemporary total knee arthroplasty (TKA) is resection of the anterior cruciate ligament (ACL). However, ACL retention can present several technical challenges, and in some cases may not be viable due to an absent or nonfunctional ACL. Therefore, the goal of this research was to investigate whether substitution of the ACL through an anterior post mechanism could improve kinematic deficits of contemporary posterior cruciate ligament (PCL) retaining implants...
November 11, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27824492/evolution-of-intrameniscal-signal-intensity-alterations-detected-on-mri-over-24-months-in-patients-with-traumatic-anterior-cruciate-ligament-tear
#19
Julio Brandao Guimaraes, Luca Facchetti, Benedikt J Schwaiger, Alexandra S Gersing, Sharmila Majumdar, Benjamin C Ma, Xiaojuan Li, Thomas M Link
OBJECTIVE: The objective of our study was to assess the prevalence and evolution of intrameniscal signal-intensity alteration in subjects with an anterior cruciate ligament (ACL) tear over 24 months and compare clinical outcome and changes of cartilage between subjects with and those without this meniscal abnormality. MATERIALS AND METHODS: Fifty-seven subjects with an ACL tear were screened for intrameniscal signal-intensity alteration. Morphologic and compositional MRI was performed before ACL reconstruction and 12 and 24 months after ACL reconstruction...
November 8, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27816290/clinical-and-arthrometric-outcomes-of-an-anatomic-outside-in-single-bundle-anterior-cruciate-ligament-reconstruction-using-a-retrodrill
#20
David Figueroa, Rafael Calvo, Francisco Figueroa, Daniel Paccot, Guillermo Izquierdo, Nelson Morales
BACKGROUND: The main option to perform an anatomic anterior cruciate ligament (ACL) reconstruction is the anteromedial portal (AMP) technique. It has several reported complications (iatrogenic chondral injury, posterior-wall blowout, short sockets, increased risk of injury to common peroneal nerve). In an attempt to avoid these complications the outside-in (OI) technique was revived with the addition of a retrodrill. The aim of this study is to evaluate the clinical and arthrometric outcomes of a series of anatomical OI single bundle ACL reconstruction using a retrodrill...
November 2, 2016: Knee
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