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posterior cruciate reconstruction

Byung Hoon Lee, Dong Ho Kum, Im Joo Rhyu, Youngjun Kim, Hyunchul Cho, Joon Ho Wang
PURPOSE: To evaluate the clinical advantages of a navigation system developed with an emphasis on attaining an appropriate femoral tunnel length and posterior wall margin with no posterior wall blowout, as well as having accurate tunnel positioning, in anatomical anterior cruciate ligament reconstruction (ACLR). METHODS: Ten freshly frozen human knees were transected at mid-femur and mid-tibia. Each knee specimen underwent arthroscopic single-bundle anterior cruciate ligament reconstruction using the outside-in technique, with two knees by manual ACLR (control group) and another eight knees by only the navigational ACLR without arthroscopic assistance (experimental group)...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Steven T Hendrix, Austin M Barrett, Bopha Chrea, William H Replogle, Josie M Hydrick, Gene R Barrett
Is there a correlation between increased posterior-inferior tibial slope angle and noncontact anterior cruciate ligament (ACL) injury? Does increasing the posterior-inferior tibial slope angle increase the risk of bilateral ACL injury? A computerized relational database (Access 2007; Microsoft Inc, Redmond, Washington) was used to conduct a retrospective review of patients undergoing bilateral or unilateral ACL reconstruction surgery or treatment by a single surgeon between 1995 and 2013. Included in the study were patients with bilateral and unilateral ACL injuries and patellofemoral pain syndrome with no associated ACL deficiency...
October 18, 2016: Orthopedics
Guido Wierer, Armin Runer, Peter Gföller, Christian Fink, Christian Hoser
BACKGROUND: Postoperative extension deficits following anterior cruciate ligament (ACL) reconstruction can cause major limitation during daily life. The purpose of this study was to evaluate the efficiency of an all-arthroscopic approach and posterior capsule release for the treatment of persistent knee extension deficits following ACL reconstruction. METHODS: Between 2009 and 2013 a total of 10 patients with knee flexion contractures after ACL reconstruction were assessed following an all-arthroscopic approach and posterior capsulotomy...
October 12, 2016: Knee
Al-Amin M Kassam, Peter J Schranz, Vipul I Mandalia
Anatomic anterior cruciate ligament reconstruction has been shown to reduce the risk of graft failure and to improve patient-related clinical outcomes. The posterior border of the anterior horn of the lateral meniscus is a useful marker for anatomic tibial tunnel placement. Assessment of a preoperative magnetic resonance imaging scan can allow surgical planning of tibial tunnel placement to allow for anatomic, patient-specific tibial tunnel placement during anatomic anterior cruciate ligament reconstruction...
August 2016: Arthroscopy Techniques
Robert Petretta, Vipul Mandalia
The use of an accessory posteromedial portal for posterior cruciate ligament reconstruction in bicruciate knee ligament reconstruction has often been described. However, the use of a posteromedial portal can be time consuming and has some inherent risks including injury to the saphenous vein or nerve. We describe our bicruciate knee ligament reconstruction using 4 exclusively anterior portals including a high anteromedial, high anterolateral, low anteromedial, and low anterolateral portals. Arthroscopy is performed using a combination of 30° and 70° arthroscopes...
August 2016: Arthroscopy Techniques
Jon O Wright, Nathan W Skelley, Reid P Schur, Ryan M Castile, Spencer P Lake, Robert H Brophy
BACKGROUND: The microstructural organization (collagen fiber alignment) of the posterior cruciate ligament (PCL), which likely corresponds with its functional properties, has only been described qualitatively in the literature, to our knowledge. The goal of this study was to quantify the tensile mechanical and microstructural properties of the PCL and compare these qualities between the anterolateral and posteromedial bundles. METHODS: Twenty-two knee specimens from 13 donors (8 male and 5 female; mean age [and standard deviation] at the time of death, 43...
October 5, 2016: Journal of Bone and Joint Surgery. American Volume
Shinichi Yoshiya
When considering the femoral attachment location for an anterolateral ligament reconstruction, the femoral attachment site should be positioned proximally and posteriorly to the lateral epicondyle to restore the physiologic length change of the native ligament. However, the clinical significance of the anterolateral ligament in patients having anterior cruciate ligament reconstructive surgery remains controversial.
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Bertrand Semay, Alexandre Rambaud, Rémi Philippot, Pascal Edouard
OBJECTIVE: This study aimed to analyze the evolution of the tibiofemoral anterior laxity during the return to sport after anterior cruciate ligament reconstruction. PATIENTS AND METHODS: Twenty patients (11 women, 9 men) with mean age of 22.4±5.1 years, operated for ACL reconstruction by a hamstring technique, competitors in a pivot-contact sport, were enrolled between September 2014 and March 2016. They were evaluated at 6 (n=20), 9 (n=13) and 12 (n=13) months postoperatively by laximetry to 250N using laximètre GnRB(®) (GenouROB, Laval, France)...
September 2016: Annals of Physical and Rehabilitation Medicine
Hirotaka Mutsuzaki, Hiromichi Fujie, Hiromi Nakajima, Makoto Fukagawa, Shunsuke Nomura, Masataka Sakane
BACKGROUND: We previously developed a novel technique using an alternate soaking process that improves tendon-bone healing by hybridizing the tendon graft with calcium phosphate (CaP). However, the effects of the CaP-hybridized tendon graft on anatomic single-bundle anterior cruciate ligament (ACL) reconstruction remain unclear. PURPOSE: To determine the effects of CaP-hybridized tendon grafts compared with untreated tendon grafts 6 months after anatomic single-bundle ACL reconstruction using a goat model...
August 2016: Orthopaedic Journal of Sports Medicine
Clemens Gwinner, Andreas Weiler, Manoussos Roider, Frederik M Schaefer, Tobias M Jung
BACKGROUND: The reported failure rate after posterior cruciate ligament (PCL) reconstruction remains high. Previous studies have shown that the tibial slope (TS) influences sagittal plane laxity. Consequently, alterations of TS might have an effect on postoperative knee stability after PCL reconstruction. HYPOTHESIS: We hypothesized that flattening of TS is associated with increased posterior laxity after PCL reconstruction. STUDY DESIGN: Cohort study; Level of evidence 3...
September 20, 2016: American Journal of Sports Medicine
Jeffrey L Milles, Clayton W Nuelle, Ferris Pfeiffer, James P Stannard, Patrick Smith, Mauricio Kfuri, James L Cook
No abstract text is available yet for this article.
September 16, 2016: Journal of Knee Surgery
Shahrzad Mohammadi Rad, Mahyar Salavati, Ismail Ebrahimi Takamjani, Behnam Akhbari, Shiva Sherafat, Hossein Negahban, Pezhman Lali, Masood Mazaheri
PURPOSE: To compare the effect of dual-tasking on postural stability between patients with anterior cruciate ligament reconstruction (ACL-R) and healthy controls. METHODS: Single-limb postural stability was assessed in 17 athletes with ACL-R and 17 healthy matched athletes while standing on a Biodex Balance System platform in four conditions: stability level of 8 (i.e. more stable support surface) with eyes open; stability level of 8 with eyes closed; stability level of 6 (i...
August 24, 2016: Journal of Sport Rehabilitation
Thomas Tampere, Tom Van Hoof, Michiel Cromheecke, Hans Van der Bracht, Jorge Chahla, Peter Verdonk, Jan Victor
PURPOSE: The purpose of this study is twofold: first, to visualize both the tibial and femoral bony insertion surfaces and second, to describe the anterior cruciate ligament (ACL) geometrically, using novel 3D CT imaging. In addition, new concepts of best-fit cylinder and central axis are introduced and evaluated. METHODS: Eight unpaired knees of embalmed cadavers were used in this study. Following the dissection process, the ACL was injected with a contrast medium for CT imaging...
September 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yuanjun Teng, Laiwei Guo, Meng Wu, Tianen Xu, Lianggong Zhao, Jin Jiang, Xiaoyun Sheng, Lihu Xu, Bo Zhang, Ning Ding, Yayi Xia
BACKGROUND: Consistent reference data used for anatomic posterior cruciate ligament (PCL) reconstruction is not well defined. Quantitative guidelines defining the location of PCL attachment would aid in performing anatomic PCL reconstruction. The purpose was to characterize anatomic parameters of the PCL tibial attachment based on magnetic resonance imaging (MRI) in a large population of adult knees. METHODS: The PCL tibial attachment site was examined in 736 adult knees with an intact PCL using 3...
2016: BMC Musculoskeletal Disorders
Brian Forsythe, Marc S Haro, Ljiljana Bogunovic, Michael J Collins, Thomas A Arns, Katie J Trella, Elizabeth F Shewman, Nikhil N Verma, Bernard R Bach
BACKGROUND: Long-term studies of posterior cruciate ligament (PCL) reconstruction suggest that normal stability is not restored in the majority of patients. The Achilles tendon allograft is frequently utilized, although recently, the quadriceps tendon has been introduced as an alternative option due to its size and high patellar bone density. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the biomechanical strength of PCL reconstructions using a quadriceps versus an Achilles allograft...
August 2016: Orthopaedic Journal of Sports Medicine
Jeffrey L Milles, Clayton W Nuelle, Ferris Pfeiffer, James P Stannard, Patrick Smith, Mauricio Kfuri, James L Cook
Objective Controversy exists regarding double-bundle (DB) versus single-bundle (SB) posterior cruciate ligament (PCL) reconstruction, with differences in multiple variables affecting biomechanical and clinical results. Our objective was to compare immediate postimplantation biomechanics of SB versus DB reconstructions to determine the relative importance of restoring both PCL bundles versus total graft volume. Methods Twenty knees were randomly assigned to five techniques (n = 4 knees/technique), performed by three surgeons experienced in their technique(s), three SB techniques (n = 12; all-inside arthroscopic inlay, all-inside suspensory fixation, and arthroscopic-assisted open onlay), and two DB techniques (n = 8; arthroscopic-assisted open inlay and all-inside suspensory fixation)...
August 20, 2016: Journal of Knee Surgery
James G Levins, Daniel R Sturnick, Erin C Argentieri, Mack Gardner-Morse, Pamela M Vacek, Michael J Desarno, Timothy W Tourville, James R Slauterbeck, Bruce D Beynnon
BACKGROUND: Anterior cruciate ligament (ACL) graft rupture occurs at a high rate, especially in young athletes. The geometries of the tibial plateau and femoral intercondylar notch are risk factors for first-time ACL injury; however, little is known about the relationship between these geometries and risk of ACL graft rupture. HYPOTHESIS: The geometric risk factors for noncontact graft rupture are similar to those previously identified for first-time noncontact ACL injury, and sex-specific differences exist...
October 2016: American Journal of Sports Medicine
Hua Xu, Yi-min Chen, Li-feng Zhai, Da-wei Bi
OBJECTIVE: To study operative effects for the treatment of multiple ligament injuries of knee joints. METHODS: From 2008 to 2013, 26 patients (17 males and 9 females) with multiple ligament injuries of knee joints were treated surgically. The average age was 40.7 years old, ranging from 29 to 55 years old. All the patients were treated with arthroscopic reconstruction of cruiate ligament with autogenous or allogeneic hamstrings and tendon, and at the same time received repair of medial collateral ligament and lateral collateral ligament, as well as the treatment of exterior and interior complex injuries...
May 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Zhen Lai, Zhi-xiang Liu, Jun-long Yang, Zhao-fei Zhang, Yi-liang Chang
OBJECTIVE: To evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints. METHODS: From March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31...
May 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jorge Chahla, Chase S Dean, Gilbert Moatshe, Justin J Mitchell, Tyler R Cram, Carlos Yacuzzi, Robert F LaPrade
Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed...
July 2016: Orthopaedic Journal of Sports Medicine
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