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Posterior Cruciate

John J Elias, Kerwyn C Jones, S Cyrus Rezvanifar, Joseph N Gabra, Melanie A Morscher, Andrew J Cosgarea
BACKGROUND: Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction. METHODS: Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability...
March 12, 2018: Knee
Jia-Ping Pan, Xu-Can Wang, Ming-Hong Huang
OBJECTIVE: To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries. METHODS: From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Gregory C Fanelli, David G Fanelli
The posterior cruciate ligament (PCL)-based multiple ligament injury, or dislocated knee, is often part of a multisystem injury complex that not only includes the knee ligaments, but may also include blood vessels, skin, nerves, fractures, and other organ system trauma. These factors must be considered in the scope of treating this complex knee injury. These complex knee ligament injuries can result in significant functional instability for the affected individual. This article will discuss multiple ligament knee injury evaluation, treatment, and special considerations in the pediatric and adolescent population...
March 13, 2018: Journal of Knee Surgery
Chae Chil Lee, Yoon Seok Youm, Sung Do Cho, Seung Hyun Jung, Mun Hee Bae, Seon Jae Park, Han Wook Kim
PURPOSE: The purpose of this study was to evaluate the association between posterior tibial slope (PTS) and anterior cruciate ligament (ACL) graft rupture in patients who have undergone ACL reconstruction by comparing results in patients who experienced graft rupture and a matched control group. METHODS: The study included 64 knees of 64 patients (58 men and 6 women), of mean age 31 years (range, 18-60 years) who underwent revision ACL reconstruction for ACL graft rupture, as well as a control group without ACL graft rupture matched for age, sex, body mass index (BMI), and left or right side...
March 9, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hyuk-Soo Han, Seung-Baik Kang
BACKGROUND: This work aimed to evaluate the changes in the femoral posterior condylar offset (PCO) and tibial slope after posterior cruciate ligament (PCL)-substituting total knee arthroplasty (TKA), and to address the presence of any interactive effect between the two on knee flexion. METHODS: Fifty-two PCL-substituting TKAs were performed using a posterior referencing system. Three-dimensional reconstructed computed tomographic (CT) images were used to evaluate PCO and tibial slope before and after arthroplasty...
March 7, 2018: Knee
Bin Xu, Hanyuan Zhang, Bo Li, Weichao Wang
To compare the direct and indirect signs on magnetic resonance imaging (MRI) for patients with acute and chronic anterior cruciate ligament (ACL) tears.Two independent reviewers retrospectively evaluated the MRI images of 377 patients with ACL tear confirmed by arthroscopy. There were 160 cases with acute ACL tear and 217 cases with chronic ACL tear. Direct signs in T1- and T2-wighted images and indirect signs including meniscus injury, the collateral ligament injury, cartilage damage or osteoarthritis, kissing contusion, Notch syndrome and abnormal posterior cruciate ligament (PCL) and other indirect signs were evaluated...
March 2018: Medicine (Baltimore)
Wei Wang, Bin Yue, JianHua Wang, Hany Bedair, Harry Rubash, Guoan Li
Inconsistent data has been reported on the effect of the femoral posterior condyle offset (PCO) on the maximal knee flexion after total knee arthroplasty (TKA). This study investigated the relationship between the postoperative changes of the PCO and the changes of maximal knee flexion after a cruciate retaining (CR) TKA. Nine patients with medial osteoarthritis (OA) in one knee were investigated. Before operation, each index knee was magnetic resonance imaging (MRI) scanned for construction of a three-dimensional (3D) knee model...
March 7, 2018: Journal of Knee Surgery
Perry Jaymes Evangelista, Nathan Lenz, Scott Laster, Neil P Sheth, Ran Schwarzkopf
Despite the overall successful outcomes following primary total knee arthroplasty (TKA) and the concept that a well-balanced TKA yields a more successful result, concerns still remain in the reported literature regarding the patellofemoral joint. Diminished outcomes have been associated with poorly balanced or placed patella implants. The effect of different techniques to achieve flexion-extension balance and the use of posterior stabilized (PS) versus cruciate retaining (CR) implant designs on patellofemoral balancing has not been previously studied...
March 7, 2018: Journal of Knee Surgery
Bart G Pijls, José W M Plevier, Rob G H H Nelissen
Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies. Methods - Migration pattern was defined as at least 2 postoperative RSA follow-up moments. Maximal total point motion (MTPM) at 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were considered. Results - The literature search yielded 1,167 hits of which 53 studies were included, comprising 111 study groups and 2,470 knees...
March 6, 2018: Acta Orthopaedica
R Samaniego Alonso, E Gaviria Parada, M Pons Cabrafiga, M Espallargues Carreras, O Martinez Cruz
INTRODUCTION: In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar...
February 28, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Ya-Jun Ma, Michael Carl, Adam Searleman, Xing Lu, Eric Y Chang, Jiang Du
PURPOSE: To develop a 3D adiabatic T1ρ prepared ultrashort echo time cones (3D AdiabT1ρ UTE-Cones) sequence for whole knee imaging on a clinical 3T scanner. METHODS: A train of adiabatic full passage pulses were used for spin locking, followed by time-efficient multispoke UTE acquisition to detect signals from both short and long T2 tissues in the whole knee joint. A modified signal model was proposed for multispoke UTE data fitting. The feasibility of this 3D AdiabT1ρ UTE-Cones technique was demonstrated through numerical simulation, phantom, and ex vivo knee sample studies...
February 28, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Jin-Soo Kim, Jung Yeol Choi, Ji-Won Kwon, Won Ryang Wee, Young Keun Han
AIM: To investigate the effects and safety of neodymium: yttrium-aluminium-garnet (Nd:YAG) laser posterior capsulotomy with vitreous strand cutting. METHODS: A total of 40 eyes of 37 patients with symptomatic posterior capsular opacity (PCO) were included in this prospective randomized study and were randomly subjected to either cruciate pattern or round pattern Nd:YAG posterior capsulotomy with vitreous strand cutting (modified round pattern). The best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive error, endothelial cell count (ECC), anterior segment parameters, including anterior chamber depth (ACD) and anterior chamber angle (ACA) were measured before and 1mo after the laser posterior capsulotomy...
2018: International Journal of Ophthalmology
Yifei Dai, Michael B Cross, Laurent D Angibaud, Cyril Hamad, Amaury Jung, Jean-Yves Jenny
PURPOSE: Posterior tibial slope (PTS) for cruciate-retaining (CR) total knee arthroplasty (TKA) is usually pre-determined by the surgeon. Limited information is available comparing different choices of PTS on the kinematics of the CR TKA, independent of the balancing of the extension gap. This study hypothesized that with the same balanced extension gap, the choice of PTS significantly impacts the intraoperatively measured kinematics of CR TKA. METHODS: Navigated CR TKAs were performed on seven fresh-frozen cadavers with healthy knees and intact posterior cruciate ligament (PCL)...
February 23, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christoph Ihle, H Nakayama, Christoph Gonser, Ulrich Stöckle, Stefan Döbele, Steffen Schröter, Marc-Daniel Ahrend, Atesch Ateschrang
BACKGROUND: The established surgical technique for lesion of the anterior cruciate ligament (ACL) is reconstruction with an autologous tendon. However, patients after ACL-replacement have increased osteoarthritis rates. Possible explanations are persistent knee instability and the loss of the ACL's proprioceptive function. Therefore, surgeons have developed an alternative treatment to preserve the ACL by readapting femoral ACL lesions by temporary protective dynamic intraligamentary stabilisation (DIS)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Ji-Hoon Bae, Jung-Ro Yoon, Ju-Hyoung Sung, Young-Soo Shin
PURPOSE: It is unknown whether the conforming superiority of ultracongruent (UC) inserts over posterior stabilized (PS) inserts, due to an increased anterior lip for prevention of anterior displacement of the condyles during knee flexion, leads to better knee scores or greater knee stability in arthroplasty patients. This meta-analysis compared clinical outcomes, intraoperative kinematics, sagittal stability, and range of motion (ROM) between groups with either UC or PS inserts in primary total knee arthroplasty (TKA)...
February 19, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kazuhisa Hatayama, Masanori Terauchi, Kenichi Saito, Jun Aoki, Satoshi Nonaka, Hiroshi Higuchi
PURPOSE: To prospectively evaluate the sensitivity and specificity of magnetic resonance imaging (MRI) for diagnosing ramp lesions, to compare them between 1.5- and 3-T MRI, and to evaluate whether bone contusion of the posterior lip of the medial tibial plateau was associated with ramp lesions. METHODS: For 155 knees that underwent primary ACL reconstruction, we prospectively examined for ramp lesions and medial meniscal body tears on MRI. MRI diagnosis of ramp lesions required high signal irregularity of the capsular margin or separation in the meniscocapsular junction of the medial meniscus posterior horn on sagittal images...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Yoshihisa Tanaka, Shinichiro Nakamura, Shinichi Kuriyama, Kohei Nishitani, Hiromu Ito, Moritoshi Furu, Mutsumi Watanabe, Shuichi Matsuda
BACKGROUND: Kinematically aligned total knee arthroplasty is based on the concept to represent the premorbid joint alignment with cruciate-retaining implants, characterized by medial tilt and internal rotation. However, kinematic and kinetic effects of kinematically aligned total knee arthroplasty with posterior-stabilized implants is unknown. The purpose of this study was to examine the effect of medial tilting of the joint line with posterior-stabilized implants. METHODS: A mechanical alignment model, and medial tilt 3° and 5° models were constructed...
February 9, 2018: Clinical Biomechanics
J Knox, V Pedoia, A Wang, M Tanaka, G B Joseph, J Neumann, T M Link, X Li, C B Ma
OBJECTIVE: To evaluate the longitudinal changes in meniscal T1ρ/T2 signal post-reconstruction in patients with acute anterior cruciate ligament (ACL) injury and to investigate the association with T1ρ/T2 signal in articular knee cartilage. METHOD: In this prospective study, knees of 37 patients with ACL-injury and reconstruction in addition to 13 healthy controls were scanned using magnetic resonance imaging (MRI) T1ρ/T2 mapping. Quantitative analysis of the meniscus was performed in the anterior/posterior horns of lateral/medial meniscus fourteen sub-compartments of cartilage spanning the medial/lateral area of the tibia and femoral condyles...
February 10, 2018: Osteoarthritis and Cartilage
Cheng-Pang Yang, Kuo-Yao Hsu, Yu-Han Chang, Yi-Sheng Chan, Hsin-Nung Shih, Alvin Chao-Yu Chen
BACKGROUND: Reports of diverse outcomes in modular mini-keel tibial componentry for total knee arthroplasty (TKA) have raised concerns about early aseptic loosening. Cruciate-retaining (CR) prostheses, using mini-keel implants, have yet to be reported and compared to posterior-stabilizing (PS) designs. METHODS: A retrospective, case-matched study of 91 consecutive TKAs (n = 46 CR; n = 45 PS prostheses), using modular mini-keel tibial componentry with a 45-mm drop down stem extension, was conducted...
February 13, 2018: Journal of Orthopaedic Surgery and Research
Santiago Pache, Zachary S Aman, Mitchell Kennedy, Gilberto Yoshinobu Nakama, Gilbert Moatshe, Connor Ziegler, Robert F LaPrade
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively...
January 2018: Archives of Bone and Joint Surgery
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