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posterior cruciate reconstruction

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https://www.readbyqxmd.com/read/29663125/arthroscopic-transtibial-pcl-reconstruction-surgical-technique-and-clinical-outcomes
#1
REVIEW
Jessica Shin, Travis G Maak
PURPOSE OF REVIEW: Posterior cruciate ligament (PCL) injuries are relatively uncommon injuries. As such, there is a dearth of high-quality studies in the literature examining the operative management of PCL injuries and a lack of clear consensus on what the optimal method should be. The goal of this review was to conduct a comprehensive evaluation of recent literature and provide an evidence-based algorithm to optimize surgical decision-making and outcomes for PCL reconstruction. RECENT FINDINGS: Recent literature confirms that transtibial PCL reconstruction is a reliable and reproducible method to manage PCL injuries and results in satisfactory patient outcomes...
April 16, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29662913/high-rate-of-missed-lateral-meniscus-posterior-root-tears-on-preoperative-magnetic-resonance-imaging
#2
Aaron J Krych, Isabella T Wu, Vishal S Desai, Naveen S Murthy, Mark S Collins, Daniel B F Saris, Bruce A Levy, Michael J Stuart
Background: Lateral meniscus posterior root tears (LMPRTs), if left untreated, can cause devastating effects to the knee, with rapid articular cartilage degeneration and loss of the meniscus as a secondary stabilizer. Detection and surgical repair of these defects have been linked to favorable outcomes, but preoperative identification of LMPRTs continues to be challenging. Purpose: To determine the rate of LMPRTs diagnosed preoperatively on magnetic resonance imaging (MRI) in a consecutive series of arthroscopically confirmed LMPRTs...
April 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29589162/the-capsular-line-reference-a-new-arthroscopic-reference-for-posterior-anterior-femoral-tunnel-positioning-in-anterior-cruciate-ligament-reconstruction
#3
Philippe Colombet, Alain Silvestre, Nicolas Bouguennec
BACKGROUND: Femoral malposition is the first cause for graft rupture during ACL reconstruction. Arthroscopic landmarks can be difficult to identify. So, landmark has to be found for reliable tunnel placement. A proximal-distal reference was described as "Apex reference" reported by Hart et al. but no posterior/anterior reference exists in the literature. The purpose of this study was to do a 3D CT-scan assessment of the femoral tunnel positioning using the Capsular Line Reference (CLR) as a landmark for posterior/anterior placement in ACL reconstruction...
March 27, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29588914/association-of-acl-laxity-tests-with-arthroscopic-findings-in-chronic-acl-and-pcl-deficient-knees
#4
S Sazali, A Rusdi, H T Siti
An anterior cruciate ligament (ACL) injury may be diagnosed by clinical examination and radiological investigation using magnetic resonance imaging or by arthroscopy.1,2 Based on our experience, the ACL tear in concomitant chronic ACL and posterior cruciate ligament (PCL) deficient knees may produce knee laxity, which is more difficult to assess on clinical examination, which in turn may affect the management algorithm of the patient. Our hypothesis is that, in a concomitant chronic ACL and PCL injury, posterior capsular contracture and abnormal reattachment of torn ACL will result in less clinical and subjective laxity, preoperatively...
January 2018: Surgery Journal
https://www.readbyqxmd.com/read/29578774/greater-static-anterior-tibial-subluxation-of-the-lateral-compartment-after-an-acute-anterior-cruciate-ligament-injury-is-associated-with-an-increased-posterior-tibial-slope
#5
Guan-Yang Song, Hui Zhang, Jin Zhang, Xin Liu, Zhe Xue, Yi Qian, Hua Feng
BACKGROUND: Static anterior tibial subluxation of the lateral compartment after an anterior cruciate ligament (ACL) injury highlights an increased anterior position of the tibia relative to the femur. However, the precise cause of this phenomenon is not entirely clear. Recently, an increased posterior tibial slope (PTS) has been identified as an independent risk factor for noncontact ACL injuries. HYPOTHESIS: An increased PTS is associated with an increased anterior position of the lateral compartment of the tibia relative to the femur after acute ACL injuries...
March 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29574163/tibial-tunnel-widening-associated-with-anterior-cruciate-ligament-reconstruction-using-autogenous-hamstrings-a-comparison-between-antero-medial-portal-and-transtibial-techniques
#6
J Silberberg Muiño, A Nilo Fulvi, G Vera, J L Gutiérrez García, M Giménez Salvay, M Maroa Salvucci, A Ruiz Ollero
OBJECTIVE: Evaluate the enlargement effect of the tibial tunnel emergence of 2 different of anterior cruciate ligament reconstruction techniques: antero-medial portal (AMP) vs. transtibial (TT) technique. METHODS: A prospective, randomized controlled study was performed in 36 consecutive patients who underwent anterior cruciate ligament reconstruction with autologous hamstring tendon grafts employing the AMP and conventional TT techniques. Lateral and antero-posterior radiographs were obtained for each patient at 6 weeks and 12 months postoperatively...
March 21, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29564211/complex-knee-injuries-treated-in-acute-phase-long-term-results-using-ligament-augmentation-and-reconstruction-system-artificial-ligament
#7
John Gliatis, Konstantinos Anagnostou, Pantelis Tsoumpos, Evdokia Billis, Maria Papandreou, Spyridon Plessas
AIM: To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System (LARS) artificial ligament to reconstruct posterior cruciate ligament (PCL). METHODS: From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS (Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late (> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combined fracture or vascular injury and use of allograft or autograft for PCL reconstruction...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29556892/successful-anterior-cruciate-ligament-reconstruction-and-meniscal-repair-in-osteogenesis-imperfecta
#8
Jae-Young Park, Tae-Joon Cho, Myung Chul Lee, Hyuk-Soo Han
A case of anterior cruciate ligament (ACL) reconstruction with meniscal repair in an osteogenesis imperfecta patient is reported. A 24-year-old female with osteogenesis imperfecta type 1a suffered from a valgus extension injury resulting in tear of ACL and medial meniscus. She underwent an arthroscopic-assisted ACL reconstruction and medial meniscus repair. Meniscal tear at the menisco-capsular junction of the posterior horn of medial meniscus was repaired with three absorbable sutures via inside-out technique...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29556890/septic-arthritis-after-arthroscopic-posterior-cruciate-ligament-and-multi-ligament-reconstructions-is-rare-and-can-be-successfully-treated-with-arthroscopic-irrigation-and-debridement-analysis-of-866-reconstructions
#9
Philipp Schuster, Markus Geßlein, Philipp Mayer, Michael Schlumberger, Raul Mayr, Jörg Richter
PURPOSE: The purpose of this study was to determine the incidence of septic arthritis following arthroscopic posterior cruciate ligament (PCL) and multi-ligament reconstructions, and to evaluate a treatment regime with sequential arthroscopic irrigation and debridement procedures combined with antibiotic therapy that is focused on retention of the graft. METHODS: Between 2004 and 2016 a total of 866 PCL reconstructions and multi-ligament reconstructions were performed at our institution (408 isolated PCL reconstructions, 458 combined reconstructions)...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29554719/femoral-footprint-for-anatomical-single-bundle-anterior-cruciate-ligament-reconstruction-a-cadaveric-study
#10
Young-Mo Kim, Yong-Bum Joo, Ki-Young Lee, Sung-Jin Hwang
Purpose: To identify the femoral footprint of the anterior cruciate ligament (ACL) in Koreans. Materials and Methods: Eighteen embalmed cadaveric knees (mean age, 70 years) were examined. First, the shape of the ACL was determined macroscopically. After the ACL femoral footprint was defined, the ACL was cut from the femur and a Kirschner wire was inserted into the center of the ACL, and the position was verified with a C-arm. The position was quantified on the C-arm field using the quadrant method...
March 19, 2018: Knee Surgery & related Research
https://www.readbyqxmd.com/read/29552481/surgical-management-of-the-multiple-ligament-knee-injury
#11
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29552479/articulated-bone-block-for-posterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-autograft-surgical-technique-to-facilitate-graft-passage
#12
Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29544985/dynamic-tracking-influenced-by-anatomy-following-medial-patellofemoral-ligament-reconstruction-computational-simulation
#13
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
https://www.readbyqxmd.com/read/29530354/does-posterior-tibial-slope-affect-graft-rupture-following-acl-reconstruction
#14
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
https://www.readbyqxmd.com/read/29525547/interactive-effect-of-femoral-posterior-condylar-offset-and-tibial-posterior-slope-on-knee-flexion-in-posterior-cruciate-ligament-substituting-total-knee-arthroplasty
#15
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
https://www.readbyqxmd.com/read/29471559/-suturing-an-acute-acl-lesion-with-dynamic-intraligamentary-stabilisation
#16
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
https://www.readbyqxmd.com/read/29456068/magnetic-resonance-imaging-diagnosis-of-medial-meniscal-ramp-lesions-in-patients-with-anterior-cruciate-ligament-injuries
#17
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
https://www.readbyqxmd.com/read/29438746/longitudinal-changes-in-mr-t1%C3%AF-t2-signal-of-meniscus-and-its-association-with-cartilage-t1p-t2-in-acl-injured-patients
#18
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
https://www.readbyqxmd.com/read/29430489/posterior-cruciate-ligament-current-concepts-review
#19
REVIEW
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
https://www.readbyqxmd.com/read/29425835/the-influence-of-internal-and-external-tibial-rotation-offsets-on-knee-joint-and-ligament-biomechanics-during-simulated-athletic-tasks
#20
Nathaniel A Bates, Rebecca J Nesbitt, Jason T Shearn, Gregory D Myer, Timothy E Hewett
BACKGROUND: Following anterior cruciate ligament injury and subsequent reconstruction transverse plane tibiofemoral rotation becomes underconstrained and overconstrained, respectively. Conflicting reports exist on how rotations influence loading at the knee. This investigation aimed to determine the mechanical effects of internal and external tibial rotation offsets on knee kinematics and ligament strains during in vitro simulations of in vivo recorded kinematics. METHOD: A 6-degree-of-freedom robotic manipulator arm was used to articulate 11 cadaveric tibiofemoral joint specimens through simulations of four athletic tasks produced from in vivo recorded kinematics...
February 2, 2018: Clinical Biomechanics
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