248 cases of avulsion of posterior cruciate ligament treated with screw fixation.- The Trickey approach through the poplitear fossa to treat the avulsion of PCL is difficult and hazardous. - From 1991-1999 at CTO, 248 cases of avulsion of PCL were treated (169 men-79 women, age 13-60, traffic accident: 229 cases). In 232 cases, we used a simplified approach which was not transcrect the gastrocnemius or expose the neurovascular structures but only retracted the medical head of gastrocnemiers to expose the posterior capsule of the knee. This technique is very easy, safe and good rehabilitation
Posterior Cruciate Ligament ; Surgery

No abstract available.
Anterior Cruciate Ligament/*surgery ; Anterior Cruciate Ligament Reconstruction/*methods ; Humans ; Knee Joint/*surgery ; Posterior Cruciate Ligament/*surgery

The widespread growth of arthroscopic techniques and their use has dramatically changed the practice of orthopaedic surgery. A high degree of clinical accuracy and minimally invasive procedure with a low surgical morbidity have encouraged the use of arthroscopy to assist in diagnosis, to determine prognosis and to provide treatment. In particular, the knee is the proper joint in which arthroscopy has its diagnostic and intraarticular surgical application. The rapid advancement of arthroscopic techniques has demonstrated a variety of surgical techniques in procedures such as meniscectomy, meniscal repair and cruciate ligament reconstruction during the last decade. This article reviews the past history of arthroscopy and technical evolution of arthroscopy in knee surgery in our department.
Anterior Cruciate Ligament/surgery ; Arthroscopy* ; Human ; Knee/surgery* ; Menisci, Tibial/surgery ; Patella/surgery ; Posterior Cruciate Ligament/surgery

Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery* ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Reconstructive Surgical Procedures ; Robotics

Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Humans ; Menisci, Tibial ; surgery ; Posterior Cruciate Ligament ; surgery ; Rotator Cuff ; surgery ; Rotator Cuff Injuries

Anterior Cruciate Ligament Injuries ; Humans ; Knee Injuries ; diagnosis ; surgery ; Medial Collateral Ligament, Knee ; injuries ; Posterior Cruciate Ligament ; injuries

OBJECTIVE: To observe the curative effect of one-stage reconstruction of anterior cruciate ligament(ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL) in patients with KD-Ⅲ-M knee injury, and to compare the operation time, hospitalization cost and curative effect after arthroscopic reconstruction of PCL with LARS artificial ligament and autogenous hamstring tendon, ACL reconstruction with autogenous hamstring tendon and MCL repair combined with limited incision. METHODS: From March 2016 to January 2019, a total of 36 patients met the criteria of this study. Twenty patients in group A were treated with autogenous hamstring tendon reconstruction of ACL and PCL and repair of MCL, including 17 males and 3 females, with an average age of (34.7±9.2) years old. Sixteen patients in group B with LARS artificial ligament reconstruction of PCL, with an autogenous hamstring tendon reconstruction of PCL and MCL repair as before as group B, including 15 males and 1 female, with an average age of (36.8±8.6) years old. The operation time, hospitalization time and total hospitalization cost were compared between the two groups. The preoperative and postoperative functions of the two groups were evaluated by Hospital for Sepcial Surgery (HSS) score and Lysholm score respectively, and the curative effects were compared within and between groups. RESULTS: All the patients in the two groups were followed up for at least 1 year. There were no complications such as infection and poor wound healing in both groups. There was significant difference in operation time between (120.25±9.55) min in group A and (106.63±8.85) min in group B ( CONCLUSION There was no significant difference in the average hospitalization days between the two groups, but the operation time in group A was longerthan that in group B, and the hospitalization cost in group B was higher than that in group A. There was no difference in HSS score and Lysholm score before and follow-up for a certain period of time after operation.
Adult ; Anterior Cruciate Ligament/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Arthroscopy ; Female ; Hamstring Tendons/surgery* ; Humans ; Knee Dislocation ; Knee Joint/surgery* ; Male ; Middle Aged ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Treatment Outcome

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

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

BACKGROUNDAllografts were widely used in anterior cruciate ligament (ACL) reconstruction for patients with ACL rupture of the knee. This study was to approve the feasibility of bone-posterior cruciate ligament-bone (BPCLB) allograft transplantation in ACL reconstruction.

METHODSEight patients underwent ACL reconstructions with BPCLB allografts and were followed up for an average period of 32 months after operation.

RESULTSSubjective parameters including International Knee Documentation Committee (IKDC), modified Larson knee ligament, Lysholm, and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively. Pivot shift test was negative in all patients. The reconstructed ACL had satisfactory shape and tension.

CONCLUSIONSBPCLB allograft is an optional choice for ACL reconstruction.

Adult ; Allografts ; Anterior Cruciate Ligament ; surgery ; transplantation ; Anterior Cruciate Ligament Reconstruction ; methods ; Humans ; Male ; Posterior Cruciate Ligament ; surgery ; transplantation ; Young Adult