Acute posterior cruciate ligament injuries

Loos, William C.; Fox, James M.; Blazina, Martin E.; Pizzo, Wilson Del; Friedman, Marc J.

doi:10.1177/036354658100900203

Cited by 119 publications

(51 citation statements)

References 15 publications

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“…Although clinical findings such as a posterior tibial sag and provocative physical examination maneuvers such as the posterior drawer and quadriceps-active test are hallmarks of PCL insufficiency, no physical examination maneuvers can differentiate a substance tear from an avulsion injury [6,7,11,14,20,32,34,36]. Therefore, radiographic analysis is critical for proper diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.

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Section: Discussionmentioning

confidence: 99%

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Most reports on PCL injuries are retrospective studies of acute and chronic PCL injuries that include a mixed population of both isolated and combined ligamentous injuries of the knee [5,11,12,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Based on these reports, it is difficult to derive a conclusion regarding the ideal management of patients with acute, isolated PCL injuries.…”

mentioning

confidence: 99%

The Nonoperative Treatment of Acute, Isolated (Partial or Complete) Posterior Cruciate Ligament-Deficient Knees: An Intermediate-term Follow-up Study

Patel

Allen

Warren

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

103

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Fifty-seven consecutive patients (58 knees) with an acute, isolated, posterior cruciate ligament (PCL) injury were treated nonoperatively. Clinical, radiographic, and functional assessment was performed at a mean follow-up of 6.9 years (range 2 to 19.3 years) after the initial diagnosis. At the time of initial documentation of the injury, the posterior drawer test was grade A in 17 knees and grade B in 41 knees. The mean preinjury Tegner activity level was 7 (range 4 to 10). At latest follow-up, 38 knees had no pain, 14 had mild pain, and 6 had moderate pain on exertion. Fifty-four knees had no swelling, 3 had mild, intermittent swelling, and 1 had a moderate swelling on exertion. The posterior drawer test was grade A in 14 knees and grade B in 44 knees. The mean Lysholm-II knee score was 85.2 points (range 51 to 100 points) and the mean Tegner activity level was 6.6 (range 3 to 10). Based on Lysholm-II knee scoring system, the results were excellent in 23 knees (40%), good in 30 knees (52%), fair in 2 knees (3%), and poor in 3 knees (5%). No statistically significant correlation (p=0.097) was seen between the grade of PCL laxity and Lysholm-II knee score. Plain radiographs showed mild (grade I) medial compartment osteoarthritis (OA) in 7 knees, and moderate (grade II) medial compartment OA in 3 knees. Mild patellofemoral OA was seen in 4 knees. We believe that most patients with acute, isolated PCL injuries do well with nonoperative treatment at a mean follow-up of 6.9 years. The level of evidence for this retrospective cohort study is level III.

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“…Thus, discriminative validity depends on the fact that measurements that lack a relationship should not be related. For example, the Lachman's test is used to determine anterior cruciate ligament injuries while the posterior drawer test is used to determine posterior cruciate ligament injuries 17 . Therefore, if a subject has an anterior cruciate ligament injury but the posterior cruciate ligament is not injured, the Lachman's test should be positive, but the posterior drawer test should be negative.…”

Section: Discriminate Validitymentioning

confidence: 99%

“…For example, the Lachman's test specificity can be analyzed by performing the test in subjects with non-injured anterior cruciate ligament but with injured posterior cruciate ligament. The tests' results would have to be negative because there would be no anterior cruciate ligament injury and the test is supposed to detect injuries to this ligament and not injuries to the posterior cruciate ligament 17 .…”

Section: Specificitymentioning

confidence: 99%

Importance and clarification of measurement properties in rehabilitation

Gadotti¹,

Vieira²,

Magee³

2006

Rev. bras. fisioter.

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Objective: The purpose of this paper was to critically review the concepts and types of measurement reliability, validity, and responsiveness, and to discuss their implications for rehabilitation research and high-quality clinical practice. Method: A critical literature review considering the strengths, limitations, and appropriate applications of measurement properties in rehabilitation was conducted. Results and Discussion: Measurement quality is assessed using criteria such as reliability, validity, and responsiveness. Many published studies do not report these measurement properties, which are related, sometimes overlapping, and are frequently confused. This review paper clarifies the meanings of the concepts and types of reliability, validity, and responsiveness. It gives examples that are relevant for the field of rehabilitation. It discusses how the measurement properties interact with each other and influence the size of the effect and the power of studies. Conclusion: Measurements are essential in rehabilitation research and clinical evaluation. Measurement properties should be reported to allow readers to evaluate the quality of the results presented. The clarification of measurement properties provided in this paper may contribute towards standardizing definitions and improving the quality of rehabilitation research and clinical practice.Key words: measurements, reliability, validity, responsiveness, study power. RESUMO Importância e Esclarecimento das Propriedades de Medida em ReabilitaçãoObjetivo: O objetivo do presente artigo foi revisar criticamente os conceitos e tipos de confiabilidade, validade e responsividade de medidas, e discutir suas implicações para a pesquisa em reabilitação e para a prática clínica de qualidade. Método: Uma revisão crítica da literatura foi realizada considerando as vantagens, as limitações e o uso adequado das propriedades de medida em reabilitação. Resultados e Discussão: A qualidade das medidas é avaliada por critérios tais como confiabilidade, validade e responsividade. Muitos estudos publicados não apresentam estas propriedades de medida as quais estão relacionadas e algumas vezes sobrepõe-se sendo freqüentemente confundidas. Este artigo de revisão esclareceu os conceitos e tipos de confiabilidade, validade e responsividade. Exemplos relevantes para a área de reabilitação foram apresentados. Discutiu-se como as propriedades de medida interagem entre si e influenciam o tamanho do efeito e o poder dos estudos. Conclusões: Medidas são essenciais na pesquisa em reabilitação e na avaliação clínica. As propriedades de medida devem ser apresentadas para permitir que o leitor possa avaliar a qualidade dos resultados apresentados. Os esclarecimentos das propriedades de medida apresentados neste artigo podem contribuir para a padronização das definições e para a melhoria da qualidade da pesquisa em reabilitação e da prática clínica.Palavras-chave: medidas, confiabilidade, validade, responsividade, poder do estudo. 138Gadotti IC, Vieira ER, Magee DJ Rev. bras. fisioter.

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Acute posterior cruciate ligament injuries

Cited by 119 publications

References 15 publications

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

The Nonoperative Treatment of Acute, Isolated (Partial or Complete) Posterior Cruciate Ligament-Deficient Knees: An Intermediate-term Follow-up Study

Importance and clarification of measurement properties in rehabilitation

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