An evaluation of the posterior cruciate ligament function in total knee arthroplasty with regard to its morphology and clinical properties

Abstract

The aim of the study was to determine the degree of posterior cruciate ligament (PCL) (Folia Morphol 2017; 76, 1: 94-99)

Comparative gait analysis of patients with different design of total knee arthroplasty

“…Currently, there are disagreements regarding the sacrifice or retention of the posterior cruciate ligament in total knee prosthesis implantation. Marczak D. et al suggest that the proprioception property of patients shows better results with the PS endoprosthesis compared to the CR implant [12]. Additionally, there are similar claims by Vanlauwe J. et al, who suggest that the implantation of the PS endoprosthesis design shows slight flexion instability, slight clinical, radiologic laxity, greater freedom of movement, as well as slight complications after the implantation compared to the CR implant [13].…”

“…The analysis of the success of knee arthroplasty using various endoprosthesis designs has been a topic of many examinations that are usually based on the use of subjective tests and the matching of patients with different types of endoprostheses [2,[11][12][13][14][15][16]. In our examination, an objective index of the gait pattern was used after knee arthroplasty in the same patient with, in one knee joint, an implanted endoprosthesis with sacrifice of the posterior cruciate ligament, and in the other, an endoprosthesis with a preserved posterior cruciate ligament.…”

Quantification of Neural Elements in Posterior Cruciate Ligament: Comparison Between Healthy Knees and With Primary Osteoarthrosis

“…Franchi, Zaccherotti and Aglietti 11 observed a statistically significant reduction in the area occupied by the neural network and mechanoreceptors in the PCL of the knees with OA in relation to normal knees (p = 0.001), findings similar to those of Çabuk et al, 2 that although they did not find a difference between knee groups with OA and normal with regard to the number of Pacini corpuscles, they observed that the number of Ruffini corpuscles, Golgi, free nerve endings and total nerve endings was significantly lower in the OA group (p < 0.05). Marczack et al 3 observed in patients with primary OA a correlation between the severity of radiographic alterations and the presence of neural elements in PCL (p < 0.0001), so that samples with high degrees of degeneration had few receptors. They also observed a significant statistically decrease in the number of neural elements in patients with OA in relation to cadavers without joint disease (p < 0.0001).…”

“…These signals offer the cognitive perception of the strength, positioning, movement, speed and direction to which the joint is submitted, contributing indispensablely to joint homeotasis. [1][2][3] Osteoarthrosis (OA) is marked by capsuloligamentous laxity, loss of articular cartilage, bone deformity and limb misalignment, factors that strongly influence the loss of proprioceptive sensitivity. It is also observed the decline in proprioceptive capacity with the aging process, which also has an important relevance when observing the degenerative joint disease, characteristically incident in older age groups.…”

“…[4][5][6] Several studies examined the difference in proprioceptive capacity after the total knee arthroplasty (TKA) and compared the results of several joint reconstruction techniques, particularly the preservation or not of the posterior cruciate ligament (PCL), among other reasons, for believing that this structure has an important proprioceptive function, [4][5][6] being demonstrated and studied the mechanoreceptors in the posterior cruciate ligament of the knee. 2,3,[7][8][9][10][11][12] However, benefits with the preservation of PCL have not been consistently observed. This may be related to a reduction in the population of mechanoreceptors with the advancing age and even faster in OA.…”