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Posterior Cruciate

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https://www.readbyqxmd.com/read/28447141/the-iliotibial-band-and-anterolateral-capsule-have-a-combined-attachment-to-the-segond-fracture
#1
Marcio Albers, Humza Shaikh, Elmar Herbst, Kentaro Onishi, Kanto Nagai, Volker Musahl, Freddie H Fu
The purpose of this report was to describe the injury mechanism, surgical findings, and outcomes in a 21-year-old professional female football player who presented with a complete anterior cruciate ligament (ACL) rupture and Segond fracture. Interview and video analysis were performed to elicit the injury mechanism. Clinical examination and imaging revealed a complete ACL tear, Segond fracture, lateral meniscus tear, MCL sprain, and posterolateral corner sprain. Examination under anaesthesia revealed Grade 2 pivot shift and varus/valgus instability...
April 26, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28447128/insufficiency-avulsion-fracture-of-the-femoral-attachment-of-the-posterior-cruciate-ligament-of-the-knee-joint
#2
Omar M Albtoush, Marius Horger
Multiple ligaments are involved in avulsion injuries of the knee joint, including both anterior and posterior cruciate ligaments; however, avulsion injury of the posterior cruciate ligament is less frequently encountered than the anterior counterpart. Furthermore, avulsion of the femoral side of the posterior cruciate ligament is far less common than the tibial one.Femoral attachment avulsion fracture of the posterior cruciate ligaments has been reported in literature in adolescents, rarely in adulthood, and never before in elderly patients, showing an inverse relationship with advancement in patient age...
April 26, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28439638/total-knee-arthroplasty-using-ultra-congruent-inserts-can-provide-similar-stability-and-function-compared-with-cruciate-retaining-total-knee-arthroplasty
#3
Eun-Kyoo Song, Hong-An Lim, Sang-Don Joo, Sung-Kyu Kim, Keun-Bae Lee, Jong-Keun Seon
PURPOSE: Recently, ultra-congruent (UC) inserts have shown successful outcomes following total knee arthroplasty (TKA). It was hypothesized that patients in the UC group would not show significantly different in vivo stability or functional outcomes from those in the cruciate-retaining (CR) group. METHODS: The prospective study enrolled patients who had been treated with either CR or UC TKAs (38 cases in each group), after a minimum 3-year follow-up. The same surgical technique was used with the same femoral components in both groups except for the polyethylene inserts (CR or UC)...
April 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28439637/tibiofemoral-rotational-alignment-affects-flexion-angles-in-navigated-posterior-stabilized-total-knee-arthroplasty
#4
Kazunari Ishida, Nao Shibanuma, Tomoyuki Matsumoto, Akihiko Toda, Shinya Oka, Kazuki Kodato, Koji Takayama, Masahiro Kurosaka, Ryosuke Kuroda
PURPOSE: To investigate the tibiofemoral rotational profiles during navigated posterior-stabilized (PS) total knee arthroplasty (TKA) and investigate the effect on post-operative maximum flexion angles. METHODS: Twenty-five subjects, treated with navigated PS TKA, were enrolled, and the effect of posterior cruciate ligament (PCL) resection and component implantation on tibiofemoral rotational kinematics was statistically evaluated. Then, the effect of rotational alignment changes on the post-operative maximum angles was retrospectively examined in 96 subjects using the multiple regression analysis...
April 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28437856/microstructure-variations-in-the-soft-hard-tissue-junction-of-the-human-anterior-cruciate-ligament
#5
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
#6
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/28433427/do-medial-pivot-kinematics-correlate-with-patient-reported-outcomes-after-total-knee-arthroplasty
#7
Lucian C Warth, Marshall K Ishmael, Evan R Deckard, Mary Ziemba-Davis, R Michael Meneghini
BACKGROUND: Many total knee arthroplasty (TKA) implants are designed to facilitate a medial pivot kinematic pattern. The purpose of this study was to determine whether intraoperative medial pivot kinematic patterns are associated with improved patient outcomes. METHODS: A retrospective review of consecutive primary TKAs was performed. Sensor-embedded tibial trials determined kinematic patterns intraoperatively. The center of rotation (COR) was identified from 0° to 90° and from 0° to terminal flexion, and designated medial-pivot or non-medial pivot based on accepted criteria...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28433391/mechanisms-of-anterior-posterior-stability-of-the-knee-joint-under-load-bearing
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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