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Posterior cruciate ligament conservative treatment

K F Schüttler, E Ziring, S Ruchholtz, T Efe
Posterior cruciate ligament (PCL) injuries are still often overlooked and treatment of a ruptured PCL is inherently different in comparison to anterior cruciate ligaments (ACL). Conservative treatment is the first-line therapy for acute isolated PCL injuries leading to good clinical and biomechanical results. Injuries to the PCL combined with rupture of other stabilizing ligaments, such as the collateral ligaments or the posterolateral corner of the knee joint are treated surgically. The same is true for high grade chronic PCL insufficiency...
January 2017: Der Unfallchirurg
John J Elias, Neil T Soehnlen, Loredana M Guseila, Andrew J Cosgarea
BACKGROUND: The current study was performed to correlate anatomical parameters related to trochlear dysplasia, tibial tuberosity position, and patella alta with in vivo patellar tracking for subjects with recurrent patellar instability. METHODS: Eight subjects with recurrent patellar instability that failed conservative treatment were evaluated using computational reconstruction of in vivo knee motion. Computational models were created from dynamic CT scans of the knee during extension against gravity...
June 2016: Knee
Dhananjaya Sabat, Atul Jain, Vinod Kumar
PURPOSE: To retrospectively compare the clinical outcomes of displaced tibial-side posterior cruciate ligament (PCL) avulsion fractures treated with open reduction and screw fixation versus arthroscopic suture fixation. METHODS: From 2005 to 2013, all displaced PCL tibial-side avulsion fractures treated surgically-initially by an open posterior approach and later by arthroscopic-assisted suture fixation-were retrospectively reviewed. The cases with radiographic evidence of greater than 3 mm of displacement and/or grade II or III laxity on the posterior drawer test were included in the study group...
January 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Fengyu Pan, Shan Hua, Zhuang Ma
BACKGROUND: The treatment of anterior cruciate ligament (ACL) rupture complicated with posterior lateral meniscus root (PLMR) tears remains controversial. The goal of this study was to evaluate clinical outcomes of PLMR tear refixation versus left untreated at the time of reconstruction. MATERIAL/METHODS: From August 2001 to January 2012, 31 patients who undergone repair of PLMR tears were evaluated and compared with a matched control group with untreated PLMR tears...
May 11, 2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ewa Kaminska, Tomasz Piontek, Marzena Wiernicka, Grazyna Cywinska-Wasilewska, Jacek Lewandowski, Dawid Lochynski
CONTEXT: The extent of knee extensor and flexor weakness after disruption of knee ligaments affects a rehabilitation output and functional recovery and may give prognostic information on a possible risk of development of knee osteoarthritis. OBJECTIVE: The hypothesis tested was whether patients with a multiple-ligament tear would have larger abnormalities in strength of the knee extensors and flexors than patients with an isolated-ligament rupture. DESIGN: Cross-sectional study, level III...
August 2015: Journal of Sport Rehabilitation
Naoya Orita, Masataka Deie, Noboru Shimada, Daisuke Iwaki, Makoto Asaeda, Kazuhiko Hirata, Mitsuo Ochi
PURPOSE: Most individuals with an isolated posterior cruciate ligament (PCL) injury do not complain of disability even if posterior instability is objectively revealed by a static physical examination, such as the posterior drawer test. This suggests it is insufficient to only evaluate posterior instability under static conditions. Therefore, we have investigated the effect of isolated PCL injury on the detailed kinematics of the knee in a dynamic environment such as during gait. METHODS: Eight unilateral PCL-deficient males and eight healthy control volunteers participated in this study...
November 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Rodrigo Salim, Fabricio Fogagnolo, Mauricio Kfuri
The integrity of posterior cruciate ligament (PCL) is essential for the normal kinematics of the knee. Injury to the PCL has adverse consequences, with worsening of functional performance and an increased risk to develop osteoarthritis. Conservative treatment is sometimes adopted, not only because it is an acceptable option for selected patients but also due to the lack of consensus in the orthopedic literature regarding the best surgical method. Hereby we describe a simplified technique for onlay PCL reconstruction pointing out possible advantages if compared with the traditional transtibial or inlay techniques...
August 2014: Journal of Knee Surgery
Vincent Morelli, Crystal Bright, Ashley Fields
This article discusses athletic injuries of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and posterolateral corner. Best evidence to date validates that conservative management of ACL ruptures is a reasonable strategy. Current data also seem to advocate nonoperative management of PCL injuries. All isolated MCL injuries, regardless of grade, are usually treated with a brief period of immobilization and symptomatic management. Although the surgical literature often advocates surgical treatment of posterolateral corner injuries, there have been no randomized trials substantiating that these injuries are best treated surgically...
June 2013: Primary Care
Wangdo Kim, Antonio P Veloso, Veronica E Vleck, Carlos Andrade, Sean S Kohles
BACKGROUND: Ligaments and cartilage contact contribute to the mechanical constraints in the knee joints. However, the precise influence of these structural components on joint movement, especially when the joint constraints are computed using inverse dynamics solutions, is not clear. METHODS: We present a mechanical characterization of the connections between the infinitesimal twist of the tibia and the femur due to restraining forces in the specific tissue components that are engaged and responsible for such motion...
March 2013: Journal of the American Podiatric Medical Association
Eric A White, Dakshesh B Patel, George R Matcuk, Deborah M Forrester, Ryan B Lundquist, George F Rick Hatch, C Thomas Vangsness, Christopher J Gottsegen
Injury to the ACL or PCL of the knee most commonly involves a tear of the collagenous fibers of the ligament. Less frequently, a cruciate ligament injury involves an avulsion fracture at the origin or insertion of the ligament, usually from the insertion site on the tibial surface. Avulsion fractures of the cruciate ligaments are important, as they can be identified on radiographs, allowing a specific diagnosis. Although more common in children, when they occur in adults, they are more commonly associated with other injuries...
October 2013: Emergency Radiology
Long-Jun Zhang, Jian-Liang Chen, Yong Xu, Shao-Bing Zhu
OBJECTIVE: To study the application of stress X-ray of knee joint for the diagnosis ot medial collateral ligament injury. METHODS: From January 2008 to June 2011, 46 patients with medial collateral ligament injury were reviewed. Among the patients, 32 patients were male and 14 patients were female, ranging in age from 28 to 72 years, with an average of (49.46 +/- 22.54) years. Left knee joint injuries occurred in 22 patients, and 24 patients had injuries in right knee joint...
November 2012: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Matthew Fernandez, David Pugh
OBJECTIVE: The purpose of this case report is to describe the evaluation and conservative management of an isolated posterior cruciate ligament (PCL) tear. CLINICAL FEATURES: A 32-year-old man with a traumatic right knee injury after tripping was initially diagnosed with medial patellar retinaculum tear at a multidisciplinary clinic. The patient received physiotherapy but reinjured the knee after returning to the sports field 3 weeks later. Subsequent clinical testing and magnetic resonance imaging confirmed a grade II isolated PCL tear...
June 2012: Journal of Chiropractic Medicine
Michael D Rosenthal, Charles E Rainey, Angela Tognoni, Robert Worms
BACKGROUND: Posterior cruciate ligament injuries are increasingly recognized, the result of various sports activities, and while most athletes return to sports the development degenerative joint changes is common. OBJECTIVE: To provide a synopsis of the current best evidence regarding the recognition and treatment of posterior cruciate ligament injuries. DESIGN: Structured narrative review. METHODS: Keyword search of Medline, CINAHL, and PEDro databases for studies published in English from January 1975 to July 2011...
November 2012: Physical Therapy in Sport
Mininder S Kocher, Brett Shore, Adam Y Nasreddine, Benton E Heyworth
BACKGROUND: There is sparse literature regarding the outcomes of treatment for posterior cruciate ligament (PCL) injuries in pediatric and adolescent patients. PCL injuries are rare and are often treated conservatively. The purpose of this study was to review 2 separate cohorts of patients with pediatric and adolescent PCL injuries: those treated surgically with direct repair or ligament reconstruction and those managed nonoperatively. METHODS: Twenty-five patients 18 years or younger underwent treatment of 26 PCL injuries (1 bilateral) at a single institution between 1993 and 2009...
September 2012: Journal of Pediatric Orthopedics
Xingshan Wang, Xisheng Weng, Jin Lin, Jin Jin, Wenwei Qian
OBJECTIVE: To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. METHODS: Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis...
May 2012: Chinese Journal of Reparative and Reconstructive Surgery
Mandeep Dhillon, Narendranadh Akkina, Sharad Prabhakar, Kamal Bali
INTRODUCTION: There is paucity of literature regarding the outcomes of ACL reconstruction in ACL deficient knees with concomitant Type A and Type B PLC injuries. MATERIALS AND METHODS: A total of 102 patients undergoing isolated ACL reconstruction for an ACL injury were evaluated prospectively in this study. The patients with divided into three groups: group A with isolated ACL injury, group B1 with concomitant Type A PLC injury and group B2 with concomitant Type B PLC injury...
December 2012: Knee
Maria Stella Peccin, Gustavo Jm Almeida, Joicemar T Amaro, Moisés Cohen, Bernardo Go Soares, Alvaro N Atallah
BACKGROUND: Injuries of the posterior cruciate ligament (PCL) of the knee frequently occur in automobile accidents and sports injuries, although they are less frequent overall than injuries of the anterior cruciate ligament (ACL). Some patients show significant symptoms and subsequent articular deterioration, while others are essentially asymptomatic, maintaining habitual function. Management of PCL injuries remains controversial and prognosis can vary widely. Interventions extend from non-operative (conservative) procedures to reconstruction of the PCL, in the hope that the surgical procedure may have a positive effect in the reduction/prevention of future osteoarthritic changes in the knee...
2012: Cochrane Database of Systematic Reviews
Rachad Zayni, Jean-Philippe Hager, Pooler Archbold, Yann Fournier, Bénédicte Quelard, Pierre Chambat, Bertrand Sonnery-Cottet
Surgical treatment of PCL tears is often indicated after conservative management failure and it is known to be challenging with unpredictable outcomes. This study aims to describe and to evaluate the outcome of an arthroscopic PCL anterolateral bundle reconstruction using a quadriceps tendon autograft. Our hypothesis is that knee stability and function can be restored using this technique allowing patients to resume their pre-injury level of activity. Between 2005 and 2008, 21 consecutive patients underwent an isolated PCL reconstruction and were evaluated after a mean follow-up of 29 months (range 12-48)...
December 2011: Knee
Craig J Edson, Gregory C Fanelli, John D Beck
Diagnosis and management of posterior cruciate ligament injuries has evolved, and now the treatment often includes surgical intervention. The purpose of this paper is to define the current approach to postsurgical management after the posterior cruciate ligament reconstruction, review conservative management, and discuss surgical outcomes using a specified program.
December 2010: Sports Medicine and Arthroscopy Review
Thore Zantop, Wolf Petersen
OBJECTIVE: Posterolateral soft-tissue reconstruction to restore knee kinematics in isolated or combined posterolateral instabilities. INDICATIONS: Isolated or multiligament knee injuries with posterolateral insufficiency (popliteus tendon, lateral collateral ligament [LCL], popliteofibular ligament). CONTRAINDICATIONS: Arthrofibrosis. Severe varus deformity. Fixed posterior drawer. Doubts about compliance. SURGICAL TECHNIQUE: Graft harvest of semitendinosus tendon...
October 2010: Operative Orthopädie und Traumatologie
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