Posterior cruciate ligament (PCL) injuries associated with multiple ligament injuries can be easily diagnosed, but isolated PCL tears are less symptomatic, very difficult to diagnose, and frequently misdiagnosed. If a detailed investigation of the history of illness suggests a PCL injury, careful physical examinations including the posterior drawer test, dial test, varus and valgus test should be done especially if the patient complains of severe posterior knee pain in >90degrees of flexion. Vascular assessment and treatment should be done to avoid critical complications. An individualized treatment plan should be established after consideration of the type of tear, time after injury, associated collateral ligament injuries, bony alignment, and status of remnant. The rehabilitation should be carried out slower than that after anterior cruciate ligament reconstruction.
Anterior Cruciate Ligament Reconstruction ; Collateral Ligaments ; Humans ; Knee ; Ligaments ; Physical Examination ; Posterior Cruciate Ligament ; Rupture

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

The purpose of this study is to compare the effects of intraoperative fixation and postoperative rehabili-tation on postoperative results in arthroscopic PCL reconstruction. We analyzed the posterior stability of the knee on 47 patients(48 knees) with posterior cruciate liga-ment injury whose posterior cruciate ligament had been recostructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from March 1993 to May 1998. The patients were divided into the two groups according to intraoperative fixation and postoperative rehabilitation. In A group, one interference screw or staple fixed in distal femur and proximal tibia irre-spective to bone quality and fixation strength during screw insertion, and rehabilitation was started as early as anterior cruciate ligament reconstruction. In B group, additional screw or staple was fixed if fixa-tion strength was weak during screw insertion, and delayed rehabilitation program was performed as schedule. Lysohm knee score was 65.3 in group A and 75.8 in group B preoperatively but 86.0 in group A and 86.5 in group B at last follow up postoperatively. posterior stability was determined by difference in pos-terior tibial translation between the injured and the opposite knee with Telos device. Differences in poste-rior tibial translation on average were 6.9 and 3.0 mmin group A and B, respectively. Conclusively, arthroscopic posterior cruciate reconstruction with firm fixation strength and delayed rehabilitation program is effective to restore more reliable posterior stability.
Anterior Cruciate Ligament Reconstruction ; Appointments and Schedules ; Chungcheongnam-do ; Femur ; Follow-Up Studies ; Humans ; Knee ; Ligaments* ; Posterior Cruciate Ligament ; Rehabilitation* ; Tibia

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

BACKGROUND: Multiple techniques are commonly used for posterior cruciate ligament (PCL) reconstruction. However, the optimum method regarding the fixation of PCL reconstruction after PCL tears remains debatable. The purpose of this study was to compare the biomechanical properties among three different tibial fixation procedures for transtibial single-bundle PCL reconstruction. METHODS: Thirty-six porcine tibias and porcine extensor tendons were randomized into three fixation study groups: the interference screw fixation (IS) group, the transtibial tubercle fixation (TTF) group, and TTF + IS group (n = 12 in each group). The structural properties of the three fixation groups were tested under cyclic loading and load-to-failure. The slippage after the cyclic loading test and the stiffness and ultimate failure load after load-to-failure testing were recorded. RESULTS: After 1000 cycles of cyclic testing, no significant difference was observed in graft slippage among the three groups. For load-to-failure testing, the TTF + IS group showed a higher ultimate failure load than the TTF group and the IS group (876.34 ± 58.78 N vs. 660.92 ± 77.74 N [P < 0.001] vs. 556.49 ± 65.33 N [P < 0.001]). The stiffness in the TTF group was significantly lower than that in the IS group and the TTF + IS group (92.77 ± 20.16 N/mm in the TTF group vs. 120.27 ± 15.66 N/m in the IS group [P = 0.001] and 131.79 ± 17.95 N/mm in the TTF + IS group [P < 0.001]). No significant difference in the mean stiffness was found between the IS group and the TTF + IS group (P = 0.127). CONCLUSIONS In this biomechanical study, supplementary fixation with transtibial tubercle sutures increased the ultimate failure load during load-to-failure testing for PCL reconstruction.
Animals ; Biomechanical Phenomena ; Posterior Cruciate Ligament Reconstruction ; Sutures ; Swine ; Tendons/surgery* ; Tibia/surgery*

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