1.Forensic Analysis of 133 Cases of Knee Injuries.
Chao ZAI ; Ling Li ZHANG ; Fang Gang HE
Journal of Forensic Medicine 2020;36(5):688-690
Objective To discuss the types, characteristics, and the evaluation of disability of knee injuries. Methods The data of 133 cases of knee injury from 2017 to 2019 were collected and statistically analyzed according to the region of injury, the degree of disability, etc. Results One hundred and twenty-five cases of injury were compound, and 8 cases were simple. The incidences of ligament injury, meniscus injury and fracture were 88.72%, 75.19% and 57.89%, respectively. Of the cruciate ligament injuries, 12 cases were posterior cruciate ligament injury while 51 cases were anterior cruciate ligament injury, and the differences between the two kinds of injury had statistical significance (P<0.05); 32 cases were secondary traumatic arthritis. The rates of disability of knee injuries were 38.35% (Grade Ⅸ and Ⅹ). Conclusion Compound knee injuries are common, and traumatic arthritis has a relatively high rate. Multiple injuries can affect the stability and weight-bearing of the knee joint. It is suggested that in addition to evaluating the range of motion of knee joint, multiple factors should be considered to assess disability.
Anterior Cruciate Ligament
;
Anterior Cruciate Ligament Injuries/epidemiology*
;
Humans
;
Knee Injuries/epidemiology*
;
Knee Joint
;
Posterior Cruciate Ligament
3.Clinical Study After Reconstruction of the Posterior Cruciate Ligament: Factors on Posterior Stability.
In Ho SEONG ; Beom Ku LEE ; Young Hun JANG ; Seung Jeong BAEK
Journal of the Korean Knee Society 1999;11(1):62-68
The goals of treatment in the injuries of posterior cruciate ligament(PCL) are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to analyze the factors on posterior stability and functional result after PCL reconstruction. From March 1996 to April 1997, twenty operation on PCL reconstruction were carried out in our hospital. The functional results according to the criteria of the Lysholm knee score and stress radiograph for posterior stability were evaluated. The average functional results evaluated by Lysholm knee score was 87. There was no significant difference in functional result according to selected grafted material, combined knee injury, type of injury and arthrotomy, etc. Difference in posterior tibial translation on average were 2.8mm in acute and 7.7mm in chronic injury. In posterolateral combined injury, average posterior tibial translation in pos- terolateral repair was 3.2mm and in posterolateral reconstruction was 9.4mm. In PCL reconstruction using hamstring with repair of PCL remnant was 2mm. In conclusion, to obtain the good result on posterior sta- bility, early PCL reconstruction using hamstring with repair of PCL remnant, and appropriate treatment on combined posterolateral injury were recommended.
Knee
;
Knee Injuries
;
Osteoarthritis
;
Posterior Cruciate Ligament*
;
Transplants
4.Clinical Implications of Bone Bruises on MRI in Acute Traumatic ACL or PCL Injury.
Sang Wook BAE ; Ho Yoon KWAK ; Chang Goo SHIM ; Baek Yong SONG ; Nam Hong CHOI ; Soo Geun YOU
The Journal of the Korean Orthopaedic Association 1999;34(1):83-88
PURPOSE: Bone bruises of patients with acute traumatic knee injuries, that are not found on simple radiograph, can be found on magnetic resonance imaging (MRI). The purpose of this study is to evaluate the frequency and locations of bone bruises on MRI in acute traumatic anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injury. MATERIALS AND METHODS: 25 and 19 MRls, in which acute traumatic ACL and PCL injury was pre sent and there was no abnormality in simple radiograph, were reviewed. MRI was taken within 51 days of injury. A bone bruise was determined as a geographic and nonlinear area of signal loss on T1 images and increased signal intensity on T2 images involving the subcortical bone. RESULTS: In 16 patients with bone bruises and acute ACL injury, bone bruises were found in the lateral compartment of the knee in 15 (93.8%) patients. The most common area was the lateral tibial plateau (11 cases, 68.8%) and the second was lateral femoral condyle (9 cases, 56.3%). In 5 patients with bone bruises and acute PCL injury, bone bruises were found in the lateral compartment of the knee in all 5 (100%) patients. The most common area was lateral tibial plateau (4 cases, 80%) and the second was lateral femoral condyle (2 cases, 40%). CONCLUSIONS: In patients with acute traumatic ACL or PCL injuries the bone bruises are often found on the lateral compartment of the knee, especially lateral tibial plateau and lateral femoral condyle on MRI.
Anterior Cruciate Ligament
;
Contusions*
;
Humans
;
Knee
;
Knee Injuries
;
Magnetic Resonance Imaging*
;
Posterior Cruciate Ligament
6.MR Imaging of the Combined Anterior and Posterior Cruciate Ligament Tears: Focussing on the Patterns of Injuries and Associated Findings.
Seon Young KWON ; Soon Tae KWON ; Chang Lak CHOI ; Dal Soo PARK ; Eun Hee PARK ; Sang Ho LEE ; Mun Kab SONG ; Kwang Won LEE
Journal of the Korean Radiological Society 1997;37(3):523-528
PURPOSE: To evaluate the patterns of injuries and frequency of associated findings on MR imaging in patients with both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears; to compare the associated findings, as seen on MR imaging, in cases with both ACL and PCL tears with those with ACL or PCL tears. MATERIALS AND METHODS: Ten patients with combined ACL and PCL tears, 16 with ACL tears and 18 with PCL tears, all confirmed by arthroscopy or open surgery, were involved in this study. To identify the associated knee injuries, MR images were retrospectively evaluated. RESULTS: In ten patients with combined ACL and PCL tears, open surgery led to the identification of six complete ACL tears (60%), four partial ACL tears (40%), eight complete PCL tears (80%) and two partial PCL tears (20%). Injuries associated with these combined tears, and revealed by MR imaging, comprised six medial collateral ligament injuries (60%), six lateral collateral ligament injuries (60%), five medial meniscal injuries (50%), three lateral meniscal injuries (30%), nine bony injuries (90%), two posterior capsular injuries (20%), and three popliteus muscle injuries (30%). The frequency of popliteus muscle injury was significantly different (p<0.05, Fisher's exact test) between the group with both ACL and PCL tears and that with ACL or PCL tears. CONCLUSION: Associated findings in patients with combined ACL and PCL tears are more frequentthan in those with ACL or PCL tears. In cases involving combined ACL and PCL tears, associated findings-as seen on MR images-should thus be carefully examined.
Anterior Cruciate Ligament
;
Arthroscopy
;
Collateral Ligaments
;
Humans
;
Knee Injuries
;
Lateral Ligament, Ankle
;
Magnetic Resonance Imaging*
;
Posterior Cruciate Ligament*
;
Retrospective Studies
7.Surgical treatment for acute posterolateral structures injuries of the knee joint in 12 patients.
China Journal of Orthopaedics and Traumatology 2012;25(5):400-403
OBJECTIVETo investigate the clinical results of surgical treatment for acute posterolateral structures(PLS) injuries of knee joint.
METHODSTwelve patients (12 knees) with acute PLS injuries were treated from May 2006 to October 2008, including 9 males and 3 females, ranging in age from 23 to 47 years, with an average of 31 years. Nine patients had posterior cruciate ligament (PCL) injuries, 3 patients had both anterior cruciate ligament (ACL) and PCL injuries, and 7 patients had articular capsule injuries. The knee joint was explored under arthroscope and the meniscuses were repaired firstly, then the ACL was rebuilt, as well as the PCL and PLS at the same time. The popliteus muscle tendon unit(PMTU) and the lateral collateral ligament (LCL) were anatomy reconstructed using variant tendon according to the degree of injury. The cruciate ligament reconstructed and fixed after the PLS reconstruction. The capsule tears were treated by reinforced suture techniques in the end. IKDC and Lysholm score were used to evaluate the postoperative knee joint function.
RESULTSAll the patients were followed up, and the duration ranged from 12 to 24 months,with an average of (16.5 +/- 3.2) months. According to IKDC standard, 8 cases restored to normal (grade A), 3 cases near to normal(grade B) and 1 poor (grade C). The preoperative Lysholm joint function score was (39.6 +/- 3.1) and improved to (85.1 +/- 2.2) after surgery. All the patients were satisfied with their operation because of no-swelling and no-pain of the knee joint.
CONCLUSIONThe acute PLS injuries should be repaired with anatomy reconstruction of the PMTU and LCL which were the most important structure of the PLS. The operative procedure required accurate establishment of the bone tunnel, protection of fibular nerve, and avoiding the incision of the variant tendon, thus can make the PLS more stable after the reconstruction.
Acute Disease ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures
8.Posterior Instability After Arthroscopically Assisted PCL Reconstruction using Bone - Patellar tendon - Bone Graft.
Seung Hee KO ; Sun Young YOON ; Sang Wook RHYU ; Chul Hun CHOI
Journal of the Korean Knee Society 1997;9(2):199-203
The posterior cruciate ligament is an anatomically and biomechanically complex structure. PCL injuries are reported to occur in 1-40% of acute knee injuries, with isolated PCL tear, less common than PCL tears combined with other Iigament injuries. Controversy exists concerning the geatment of the PCL injures. Recently, arthroscopic techniques of PCL reconstruction are becoming nore refined and reproducible. Between July 1993 and May 1995, 25 operations for PCL rupture were performed in our hospital. At the follow-up examinations we noted mild to moderate posterior instablilty which was not noted at the time of operation and during the immediate postoperative period. We reviewed type (if injuries, amplitude of initial posterior tibia1 translation, surgical techniques, which seemcd to be in relation ivith the postoperative instabilities. At final follow-up, the mean Lysholm knee score was 86 points, and the posterior tibial translation 6.5mm on posterior stress radiographs. The ligament augmentation device provided no benefit. The ideal positioning and fixation of the graft and protection of the graft from abrasion seemed to be important to get a good results.
Follow-Up Studies
;
Knee
;
Knee Injuries
;
Ligaments
;
Patellar Ligament*
;
Posterior Cruciate Ligament
;
Postoperative Period
;
Rupture
;
Transplants*
9.Clinical effect of one-stage arthroscopically assisted repair and reconstruction for posterolateral dislocation of knee joint with multiple ligament injuries.
Meng WU ; Li GAO ; Ya-yi XIA ; Shuan-ke WANG
China Journal of Orthopaedics and Traumatology 2014;27(8):686-690
OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.
METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.
RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.
CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.
Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods
10.The Displaced Bucket-Handle Tear of the Meniscus: MRi Findings.
Young Mi KWON ; Seon Kwan JUHNG ; Jong Jin WON ; Gyung Hi PARK ; Gang Deuk KIM
Journal of the Korean Radiological Society 1994;31(1):145-150
PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament
;
Collateral Ligaments
;
Diagnosis
;
Humans
;
Joints
;
Knee
;
Knee Injuries
;
Magnetic Resonance Imaging*
;
Posterior Cruciate Ligament
;
Retrospective Studies