1.Study on the diagnostic value of different posterior cruciate ligament index measurement methods for anterior cruciate ligament injury.
Jun YANG ; Yuan-Jun TENG ; Zun-Lin WANG ; Zhong-Cheng LIU ; Si-Jie CHEN ; Xue-Ping WU ; Yong-Kang NIU ; Ya-Yi XIA
China Journal of Orthopaedics and Traumatology 2023;36(10):926-931
OBJECTIVE:
To compare the posterior cruciate ligament(PCL) index with six different measurement methods, and analyze and verify its clinical diagnostic value in anterior cruciate ligament (ACL) injury.
METHODS:
The Magnetic resonance imaging (MRI) data of 225 knee joints in our hospital from May 2018 to March 2022 were retrospectively analyzed, aged from 18 to 60 years old, with a median of 32 years old. On the sagittal MRI images of 114 patients with ACL injury and 111 patients with intact ACL, Measure the straight-line distance (A) between the femoral attachment point and the tibial attachment point of the PCL on the MRI sagittal image and the maximum vertical distance (B) between the straight line and the arcuate mark point of the PCL on the sagittal image, calculate the PCL index and evaluate the diagnostic value of the PCL index for ACL injury.
RESULTS:
The PCL index of the ACL normal group and the ACL injury group were statistically described. There was no significant difference in PCL index 1, 2, 3 and 6 between the two groups(P>0.05). The difference of PCL index 4 and 5 between the two groups was statistically significant (P<0.001). This study only found that the PCL index 2, 6 in the ACL normal group had a negative correlation with the patient's age (correlation coefficient=-0.213, -0.819;P<0.05), and the PCL index 5 in the ACL injury group was significantly correlated with the patient's body mass index(BMI)had a negative correlation (correlation coefficient=-0.277, P<0.05).
CONCLUSION
The change of PCL index is helpful for the diagnosis of ACL injury, PCL index 4 and 5 can be used as effective reference indexes for diagnosing ACL injury in clinic.
Humans
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Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Posterior Cruciate Ligament/diagnostic imaging*
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Anterior Cruciate Ligament Injuries/diagnostic imaging*
;
Anterior Cruciate Ligament
;
Retrospective Studies
;
Knee Joint
;
Magnetic Resonance Imaging/methods*
2.Observation of clinical effects of surgery for trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament avulsion fracture.
Wei LI ; Wei-Feng JI ; Zhen-Chuan MA
China Journal of Orthopaedics and Traumatology 2014;27(5):422-424
OBJECTIVETo investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.
METHODSFrom September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.
RESULTSFive patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.
CONCLUSIONFor the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.
Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome
3.Ganglion cyst of the posterior cruciate ligament in a child.
Shamsi Abdul HAMEED ; Premjit SUJIR ; Monappa A NAIK ; Sharath K RAO
Singapore medical journal 2012;53(4):e80-2
Ganglion cysts are more commonly associated with the anterior cruciate ligament than the posterior cruciate ligament (PCL). A literature review showed that all reported cases of ganglion cysts to date involved adults. We report a rare case of ganglion cyst in the PCL of a four-year-old boy, and discuss its aetiology, clinical presentation, imaging features and management. Ganglion cysts of the PCL may be confused with meniscal cysts arising from tears of the posterior horn of the medial meniscus on magnetic resonance (MR) imaging. Hence, the posterior horn of the medial meniscus has to be carefully evaluated to rule out a tear. MR imaging is the method of choice to confirm diagnosis, and arthroscopic resection is a safe treatment modality even in children.
Arthroscopy
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Child, Preschool
;
Ganglion Cysts
;
diagnosis
;
surgery
;
Humans
;
Knee Joint
;
diagnostic imaging
;
Magnetic Resonance Imaging
;
Male
;
Posterior Cruciate Ligament
;
injuries
;
pathology
;
Radiography
4.Treatment of tibial avulsion fracture of the posterior cruciate ligament with open reduction and steel-wire internal fixation.
Hua-ding LU ; Chun ZENG ; Yun-xu DONG ; Dao-zhang CAI ; Xiao-yue WEN
China Journal of Orthopaedics and Traumatology 2011;24(3):195-198
OBJECTIVETo study the curative effects of the treatment of tibial avulsion fracture of the posterior cruciate ligament with open reduction and steel-wire internal fixation.
METHODSFrom January 2003 to June 2009, 28 patients of tibial avulsion fracture of the posterior cruciate ligament were treated with open reduction and steel-wire internal fixation through posteromedial inverted "L" approach. There were 19 males and 9 females with an average age of 35.3 years old ranging from 16 to 55 years. The X-ray examination showed that there were II degree displaced in 10 cases and III degree in 18 patients. The affected lower extremity was put in a controlled hinge knee brace after operation. The patients were asked to do passive extension and flexion of the knee joint with the assistance of a CPM 2 weeks after operation,and allowed to be partial weight-bearing as tolerated with the hinged brace locked in extension if concomitant injuries allowed 4 weeks postoperatively. The brace were removed 6 weeks later.
RESULTSAmong them, 25 patients were followed up for 6 to 24 months with an average of 15 months. The X-ray examination showed satisfactory reduction, and bony union was obtained in all the patients. The Lachman test was negative in all patients. No complications such as malunion or joint stiffness were found. The extension of affected knee was normal and its flexion were (136 +/- 12) degrees. According to Lysholm knee score system,it was preoperatively (41.80 +/- 6.16) and (94.10 +/- 8.26) six months after surgery respectively. Twenty-two cases were excellent, 2 cases good and 1 fair.
CONCLUSIONTreatment of tibial avulsion fracture of the posterior cruciate ligament with open reduction and internal fixation with wires through posteromedial inverted "L" approach is a safe, effective method, due to its stable fixation and relatively low expense. It is believed as an ideal choice for tibial avulsion fracture of the posterior cruciate ligament.
Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
5.Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw.
Wei CHEN ; Wei LUO ; Zhiqing CHEN ; Yi JIANG
Singapore medical journal 2016;57(1):39-44
INTRODUCTIONTo investigate the feasibility and clinical efficacy of using a toothed plate and hollow lag screw in the surgical treatment of posterior cruciate ligament (PCL) avulsion fractures of the tibia.
METHODSA total of 21 patients were treated with open reduction and internal fixation using a toothed plate and hollow lag screw, through a posteromedial approach using an inverted L-shaped incision. The patients were allowed appropriate functional exercises, including knee flexion and extension, after removal of the plaster at postoperative weeks 3-6. The follow-up period was between six months and two years.
RESULTSThis was a retrospective study of patients with PCL avulsion fractures of the tibia caused by road traffic accidents (n = 9), sports-related injuries (n = 6), falls (n = 5) and machinery-related injuries (n = 1). 20 patients presented with fresh fractures and one with an old fracture. The patients (13 men, eight women) had a mean age of 41.5 (range 19-72) years. Anatomical reduction of the fracture and satisfactory fixation were achieved in all 21 patients. Bony union was achieved in all patients at 8-12 weeks after surgery. Six months after surgery, knee flexion was 121.9° ± 10.4° and extension was 0°. According to the Lysholm Knee Scoring Scale, 19 patients were rated as 'excellent' and two as 'good'.
CONCLUSIONThe use of a toothed plate and hollow lag screw could be a simple and reliable approach for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery.
Adult ; Aged ; Arthroscopy ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Avulsion ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Retrospective Studies ; Tibial Fractures ; diagnosis ; surgery ; Young Adult