Posterior Cruciate

Failure rates among primary Anterior Cruciate Ligament Reconstruction (ACLR) range from 3.2% to 11.1%. Recently, there has been increased focus on surgical and anatomic considerations which predispose patients to failure, including excessive posterior tibial slope (PTS), unaddressed high-grade pivot shift, and improper tunnel placement. The purpose of this review was to provide a current summary and analysis of the literature regarding patient-related and technical factors surrounding revision ACLR, rehabilitation considerations, overall outcomes and return to sport (RTS) for patients who undergo revision ACLR...

Tibial-sided posterior cruciate ligament avulsion fractures are challenging injuries that often occur concomitantly in the setting of multiligament knee and other soft-tissue injuries. There is no consensus on the optimal surgical approach or timing of treatment for these injuries. This Technical Note describes the fixation of a displaced posterior cruciate ligament avulsion fracture with concomitant grade 3 medial collateral ligament injuries and bucket-handle lateral meniscus tears using open and arthroscopic techniques...

CASE: A 51-year-old man and 64-year-old woman with bilateral cruciate-retaining total knee arthroplasties (CR-TKAs) who sustained unilateral periprosthetic distal femur fractures above their CR-TKA and experienced knee instability secondary to an iatrogenic posterior-cruciate-ligament (posterior cruciate ligament [PCL]) injury from retrograde intramedullary nailing. Both patients recovered knee stability after undergoing revision surgery. CONCLUSION: Many CR-TKA designs have sufficient medial-lateral intercondylar distance to place a retrograde nail, femoral components with a relatively posterior transition from the trochlear groove to the intercondylar box will necessitate a nail starting point closer to the PCL origin...

BACKGROUND: The ideal position of the femoral bone tunnel in the anterior cruciate ligament (ACL) is controversial. The functional importance of the ACL fiber varies depending on where it is attached to the femur. Functionally important fibers can cause high mechanical stress on the bone, and the Wolff law predicts that bone mineral density will increase at high mechanical stress sites. PURPOSE/HYPOTHESIS: The purpose of this study was to use computed tomography imaging to determine the distribution pattern of bone density in the lateral intercondylar wall...

BACKGROUND: This study aimed to meta-analyze epidemiological data, revision rates, and incidences of different designs of a single Total Knee Arthroplasty System and compare these factors across different countries. METHODS: A systematic review was conducted on clinical studies and arthroplasty registries of ATTUNE TKA from 1999 to 2020. The main endpoints analyzed were revision rates and epidemiological data. RESULTS: The average age of patients was 67...

BACKGROUND: The posterior cruciate ligament (PCL) attachment may be damaged in cruciate-retaining total knee arthroplasty (CR-TKA) using the complete resection for tibial preparation, and resection amount varies greatly among individuals. Discoid lateral meniscus (DLM) is one of the most common anatomic knee variants. This study aimed to evaluate the difference in PCL attachment sacrifice in CR-TKA between patients with and without DLM. METHODS: Fifty-one knees in the study group (DLM group) were matched 1:1 to 51 control knees (non-DLM group) by age, sex, and maximum width of the tibial plateau...

INTRODUCTION: Ramp lesions, often associated with anterior cruciate ligament (ACL) injuries, exhibit a varied incidence rate of 9-42%, increasing with delayed ACL reconstruction. These lesions, resulting from abnormal tibial movements and semimembranosus muscle contraction, are challenging to diagnose due to their hidden nature in standard magnetic resonance imaging and arthroscopy procedures. CASE REPORT: This report examines the case of a ramp lesion in the context of a multi-ligament injured knee of a 34-year-old male...

The posterior cruciate ligament (PCL), one of the key ligaments in the knee, serves to prevent backward movement of the tibia relative to the femur. A simultaneous occurrence of a PCL avulsion fracture and a femur shaft fracture in a pediatric patient suggests a complex orthopedic injury resulting from significant trauma to the knee and thigh area. This study describes the rehabilitation process of a 12-year-old female involved in a road traffic accident, who suffered both a midshaft femur fracture and a PCL avulsion fracture...

INTRODUCTION:  Genetic and anatomical factors have been reported as risk factors for anterior cruciate ligament (ACL) injuries. This study aimed to investigate anatomical characteristics in family members sustaining ACL injuries, compared with age- and sex-matched patients with simple meniscus injuries. MATERIALS AND METHODS:  Medical records of 1548 patients who underwent ACL reconstruction were reviewed. Cases of ACL injury occurring in first-degree relatives were selected...

BACKGROUND: Whether cruciate ligament forces in cruciate-preserving designs, such as unicompartmental knee arthroplasty (UKA) or bi-cruciate-retaining total knee arthroplasty (BCR-TKA), differ from those in normal knees remains unknown. The purpose of this study was to compare the in vivo kinematics and cruciate ligament force in knees before and after UKA or BCR-TKA to those in normal knees during high-flexion activity. METHODS: Overall, twenty normal knees, 17 knees with medial UKA, and 15 knees with BCR-TKA were fluoroscopically examined while performing a squatting activity...

BACKGROUND: Outcomes after posterior cruciate ligament (PCL) reconstruction (PCLR) have been reported to be inferior to those of anterior cruciate ligament reconstruction. Furthermore, combined ligament injuries have been reported to have inferior outcomes compared with isolated PCLR. PURPOSE/HYPOTHESIS: The purpose of this study was to report on PCLR outcomes and failure rates and compare these outcomes between isolated PCLR and multiligament knee surgery involving the PCL...

INTRODUCTION:  Posterior cruciate ligament injuries are uncommon, and their management is controversial. However, surgical reconstruction is necessary in case of symptomatic lesions. The present study aimed to analyse patients' reported outcomes and clinical evaluation after isolated posterior cruciate ligament reconstruction. MATERIALS AND METHODS:  The present study includes 12 patients with posterior cruciate ligament rupture. All patients were treated with arthroscopic surgery using single-bundle hamstring autograft ligament reconstruction...

BACKGROUND: Increased posterior tibial slope (PTS) leads to a relative anterior translation of the tibia on the femur. This is thought to decrease the stress on posterior cruciate ligament (PCL) reconstruction (PCLR) grafts. PURPOSE/HYPOTHESIS: The purpose of this study was to analyze the effect of PTS on knee laxity, graft failure, and patient-reported outcome (PRO) scores after PCLR without concomitant anterior cruciate ligament reconstruction (ACLR). It was hypothesized that patients with higher PTS would have less knee laxity, fewer graft failures, and better PROs compared with patients with lower PTS...

PURPOSE: The purpose of this study is to assess the current literature surrounding suture tape augmentation (STA) of posterior cruciate ligament reconstruction (PCLR) with additional evaluation of PCLR+STA in clinical practice. METHODS: A systematic search of three databases (PubMed, EMBASE, and Web of Science Core Collection) was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was completed April 2023 to identify studies related to PCLR+STA...

OBJECTIVES: To evaluate the type and prevalence of associated injuries by using magnetic resonance imaging (MRI) in patients with anterior cruciate ligament (ACL) tears. METHODS: Data from the Natural Corollaries and Recovery after ACL injury multicenter longitudinal cohort study were analyzed. Between May 2016 and October 2018, patients aged between 15 and 40 years, who had experienced an ACL tear within the last 6 weeks and sought medical attention at one of seven healthcare clinics in Sweden, were invited to participate...

OBJECTIVE: The primary aim of this study was to investigate the immediate and delayed effects of kinesiotape (KT) on postural control and patient-reported outcome measures under challenging conditions in individuals with anterior cruciate ligament reconstructions. METHODS: Thirty-two anterior cruciate ligament-reconstructed patients for whom 6 months had passed since their operation were randomly assigned to either the KT (n = 16, aged 21.8 [5.5] y) or the placebo KT (n = 16, aged 24...

CONTEXT: A reduced knee extensor moment (KEM) in the involved limb and asymmetry in the KEM during landing tasks are observed after anterior cruciate ligament reconstruction (ACLR). There is limited information about the association of kinetic and kinematic parameters with the KEM during landing after ACLR. This study investigated the association of the anterior-posterior center of pressure (AP-COP) position, vertical ground reaction force (VGRF), and lower limb joint angles with the KEM during landing in female athletes following ACLR...

Tibiofemoral slip velocity is a key contributor to total knee arthroplasty (TKA) component wear, yet few studies have evaluated this quantity in vivo. The aim of the present study was to measure and compare tibiofemoral slip velocities in 3 TKA designs for a range of daily activities. Mobile biplane X-ray imaging was used to measure 6-degree-of-freedom tibiofemoral kinematics and the locations of articular contact in 75 patients implanted with a posterior-stabilized, cruciate-retaining, or medial-stabilized design while each patient performed level walking, step up, step down, sit-to-stand, and stand-to-sit...

PURPOSE: Numerous methods have been proposed to characterise tubercle lateralisation. However, their normal values and related changes remain unclear. Accordingly, it was aimed to determine the potential sex and age effects and determined the optimal individualised method of diagnosing lateralisation of the tibial tubercle in patients with recurrent patellar dislocation (RPD). METHODS: Measurements included the tibial tubercle-trochlear groove (TT-TG) distance, tibial tubercle-posterior cruciate ligament (TT-PCL) distance and tibial tubercle lateralisation (TTL); and the proximal tibial width (PTW), trochlear width (TW) and trochlear dysplasia index (TDI), for adjustment...

A variety of total knee arthroplasty (TKA) designs offer increased congruency bearing options, primarily to compensate for a loss of posterior cruciate ligament (PCL) function. However, their efficacy in providing sufficient stability under different circumstances requires further investigation. The preclinical testing of prosthesis components on joint motion simulators is useful for quantifying how design changes affect joint stability. However, this type of testing may not be clinically relevant because surrounding ligaments are either ignored or greatly simplified...