A rare case of bony avulsion of posterior cruciate ligament from its femoral attachment

Mishra, Anil K.; Vikas, Rohit

doi:10.1016/j.mjafi.2015.11.014

Cited by 8 publications

(7 citation statements)

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“…Many reports on the use of this method have been published in recent years. 17,18 However, there were still some sources of selection bias in the present study because of the patients' social, economic, and cultural statuses. During the long-term follow-up, patients with a poor or low socioeconomic level showed poor adherence to the rehabilitation program and failed to give feedback to doctors during the telephone and outpatient follow-ups.…”

Section: Discussionmentioning

confidence: 90%

Long-term outcomes after arthroscopic single-bundle reconstruction of the posterior cruciate ligament: A 7-year follow-up study

et al. 2017

J Int Med Res

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ObjectiveArthroscopy is the most popular technique in posterior cruciate ligament (PCL) reconstruction surgery. However, no consensus on long-term outcomes after arthroscopic PCL reconstruction has been reached. This study was performed to evaluate the long-term outcomes after arthroscopic autologous hamstring or allogeneic tendon single-bundle reconstruction of the PCL.MethodsFifty-eight patients who underwent arthroscopic PCL reconstruction in Anhui, China from 2007 to 2009 were included. The follow-up period ranged from 56 to 83 months. During the follow-up, the Lysholm knee score and Tegner activity score were used to assess knee function. The KT-2000 arthrometer (MEDmetric Corp., San Diego, CA, USA) was used to assess the stability of the reconstructed PCL.ResultsThe mean Lysholm score, mean Tegner score, and mean forward and backward displacements were not significantly different between the final follow-up and 1 year after the surgery. Additionally, no significant differences were observed in any of the above-mentioned parameters between autologous and allogeneic reconstruction at the final follow-up.ConclusionBoth autologous and allogeneic reconstruction had few complications and satisfactory long-term outcomes.

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Section: Discussionmentioning

confidence: 90%

Long-term outcomes after arthroscopic single-bundle reconstruction of the posterior cruciate ligament: A 7-year follow-up study

et al. 2017

J Int Med Res

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“…With the development of arthroscopic techniques, treatments for this kind of injury were developed to perform minimally invasive surgeries using arthroscopy 9–11, 21 . Mishra et al 8 . removed an avulsed fragment from the PCL in a patient who had injured his knee 1 year previously.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the injuries were accompanied by other soft tissue injuries. Only 4 of all 10 adult cases were isolated partial avulsed fractures 8,10,11,28 . Therefore, we conducted this study to investigate the manifestation, mechanisms, and appropriate treatment of isolated partial femoral avulsion fractures of the PCL in adults.…”

Section: Discussionmentioning

confidence: 99%

“…Adults are far less likely than children and teenagers to experience these injuries. In early reports (before 2012), most cases of adult avulsion fractures of the PCL from femoral insertion were in individuals below the age of 25 years [8][9][10][11] ; it was suggested that this was attributed to the incomplete development of ligament insertion 10 . However, after a comprehensive search of the literature in recent years, we found that the number of patients aged above 25 years is rising.…”

Section: Introductionmentioning

confidence: 99%

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Isolated Partial Femoral Avulsion Fracture of the Posterior Cruciate Ligament in Adults

Liu

Gui

Zhao

et al. 2021

Orthopaedic Surgery

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Objective: To investigate the manifestation, mechanisms, and treatment of isolated partial femoral avulsion fractures of the posterior cruciate ligament (PCL) in adults.Methods: From January 2011 to December 2018, we retrospectively reviewed the clinical data of three patients with isolated partial femoral avulsion fractures of the PCL who were admitted to our institution. All of these patients were admitted to our emergency department within 24 h after injury. After physical examination and radiographs were taken and reviewed, all patients were admitted and underwent surgical treatment. In a 26-yearold man who underwent arthroscopic surgery through the traditional medial and lateral approach before finally converting to open surgery with the posterior approach, the fragment that was finally removed was partially attached to the PCL. In the other two patients, women aged 63 and 68 years, who underwent arthroscopic surgery via the traditional medial and lateral approach, the fragments were large and attached to most fibers of the PCL. We fixed the fragments using hollow screws in arthroscopic view. In addition, in the 63-year-old patient, an anchor was embedded to restore the tension of the PCL. Four weeks after surgery, the patients started to wear long leg braces in full extension with the tibia blocked up by cushion. Physical examinations were conducted and radiographs were taken preoperatively and at 4 weeks and 3 months after surgery to evaluate the condition of the injury. The range of motion and the Lysholm knee scoring scale for the knee joint were compared before and after the surgery.Results: For the three patients, the radiographs taken at 3 months postoperatively showed that the fixation of the screws did not fail, and the subchondral bone was generally normal compared to the preoperative radiographs. CT scanning at 3 months after surgery showed that the fracture healed in the original position of the avulsion site. For all patients, the affected knees presented as stable at physical examination 3 months after surgery; the Lachmann test and the anterior drawer test results were negative. In addition, the flexion-extension, internal rotation, and external rotation were approximately 0 -130 , 0 -30 , and 0 -40 in the 26-year-old patient, respectively. The flexion-extension, internal rotation, and external rotation were approximately 0 -100 , 0 -20 , and 0 -35 for the 63-year-old patient, respectively. The flexion-extension, internal rotation, and external rotation were approximately 0 -100 , 0 -15 , and 0 -20 for the 68-year-old patient, respectively. There was no pain or only little pain 3 months after surgery. There was no swelling or discomfort at the 3-month follow up. The Lysholm knee scores of the 68-year-old, 63-year-old, and 26-year-old patient were 80, 87, and 95 at 3 months after surgery, respectively, which were obviously improved postoperatively. Conclusion:The manifestation of isolated partial femoral avulsion fractures of the PCL in adults is often related to the injury mechanism, and surge...

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“…This may be partly attributed to the fact that osteochondral avulsions of the PCL can be easily misdiagnosed on plain radiographs in children. In recent years, arthroscopic treatments of avulsion fractures from the tibial insertion of the PCL have been reported, but publications on the femoral avulsion of the PCL are still rare, and a “gold standard” of treatment is not yet available. This paper presented an extremely rare case of a PCL avulsion from the femoral insertion in association with a meniscus tear as well as its arthroscopic management in a child.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Treatment of Femoral Avulsion Fracture of the Posterior Cruciate Ligament in Association with Meniscus Tear

Zhao

Kuang

et al. 2020

Orthopaedic Surgery

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Background: Femoral avulsion fracture of the posterior cruciate ligament (PCL) in association with meniscus tear is extremely rare in children, and similar cases are not available in the existing literature. Case presentation:In this paper, we present a case of a 9-year-old boy treated by an arthroscopic repair technique using two transfemoral tunnels sparing the epiphyseal plate for 8-shaped suture fixation of femoral avulsion fracture of the PCL and using the Fastfix repair system for a meniscus tear. At 3-month postoperative, the boy showed satisfactory recovery with a full range of motion of the right knee and normal muscular strength, and no complications were observed after operation. The patient had been followed up for 24 months and his final assessment demonstrated stable painless knee with excellent functional outcome. In view of this, we suggest that the "figure-of-eight" suture technique using two transfemoral tunnels sparing the epiphyseal plate can be considered a new choice for the treatment of the PCL femoral attachment avulsion, especially in skeletally immature patients. In addition, six similar cases were found in a comprehensive literature review targeting femoral avulsion fracture of the PCL. According to the relevant findings and cases studies, we proposed a new classification named "Xiangya" which might facilitate future clinical decision making.

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A rare case of bony avulsion of posterior cruciate ligament from its femoral attachment

Cited by 8 publications

References 8 publications

Long-term outcomes after arthroscopic single-bundle reconstruction of the posterior cruciate ligament: A 7-year follow-up study

Long-term outcomes after arthroscopic single-bundle reconstruction of the posterior cruciate ligament: A 7-year follow-up study

Isolated Partial Femoral Avulsion Fracture of the Posterior Cruciate Ligament in Adults

Arthroscopic Treatment of Femoral Avulsion Fracture of the Posterior Cruciate Ligament in Association with Meniscus Tear

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