In Vitro Study of Knee Stability After Posterior Cruciate Ligament Reconstruction

Pearsall, Albert W.; Pyevich, Michael; Draganich, Louis F.; Larkin, J J; Reider, Bruce

doi:10.1097/00003086-199606000-00033

Cited by 44 publications

(24 citation statements)

References 35 publications

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“…24,25 Another study, using a constrained test rig with one degree of freedom, found the opposite trend. 15 Pearsall et al 15 tested an isometric bone-patellar tendonbone graft. They matched posterior laxity to normal in knee extension, but then found 7 mm of excess laxity at 90° of knee flexion, findings similar to our isometric graft results.…”

Section: Discussionmentioning

confidence: 99%

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PCL reconstruction

Race

Amis

1998

The Journal of Bone and Joint Surgery. British volume

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W e compared the ability of three different posterior cruciate ligament (PCL) reconstructions to restore normal anteroposterior laxity to the knee from 0 to 130° of knee flexion.Cadaver knees were tested intact, after PCL rupture or after bone-patellar tendon-bone grafting. Grafts were performed isometrically or with a single bundle representing the anatomical anterior PCL fibre bulk (aPC) or with a double bundle that added the posterior PCL fibre bulk (pPC). The grafts were tensioned to restore normal knee laxity at 60° of flexion, except for the pPC which was tensioned at 130°.The isometric graft led to overconstraint as the knee extended resulting in high graft tension in extension and excess laxity in flexion. The aPC graft matched normal laxity from 0 to 60° of flexion but was lax from 90 to 130° of flexion. Only the double-bundled graft could restore normal knee laxity across the full range of flexion.

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Section: Discussionmentioning

confidence: 99%

“…It has been assumed that this prevents overloading the graft as a result of the changes in length on movement, although the restoration of acceptable anteroposterior (AP) tibial laxity may not be possible. 15 The fibres of the PCL fan out from a small tibial attachment to a femoral attachment that is typically 30 mm across 16 ( Fig. 1).…”

mentioning

confidence: 99%

PCL reconstruction

Race

Amis

1998

The Journal of Bone and Joint Surgery. British volume

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“…Previous in vitro studies (Gollehon et al, 1987;Pearsall et al, 1996) quantified the translation of the tibia relative to the femur before and after sectioning the PCL, and showed that posterior shift of the tibia increased with knee flexion when a posteriorly directed force was applied. Moreover, the abnormal translation and rotation of the tibia became more serious with knee flexion in a PCL-ruptured knee.…”

Section: Discussionmentioning

confidence: 99%

The effect of posterior cruciate ligament deficiency on knee laxity

Wu¹,

Liau

Wei³

et al. 2009

Journal of the Chinese Institute of Engineers

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Partial posterior cruciate ligament (PCL) injuries often occur in athletes; however, limited information is available about the laxity of knees with different degrees of PCL injury. In this study, a three-dimensional finite element model of the human tibiofemoral joint with articular cartilage layers, menisci and four main ligaments was constructed to investigate the changes in the knee laxity for different PCL injuries. The simulation of PCL injury (slight, medium, severe, and rupture) was simplified by reducing the elastic modulus (25%, 50%, 75%, and 100%) of the intact PCL. A posterior tibial force (100 N, 200 N) was applied to the knee joint at 0°, 30°, 60°, and 90°o f flexion. The boundary conditions included constraining all degrees of freedom at the top surface of the femur and assuming non-constraint on the bottom of the tibia except for flexion-extension motion. Under 100 N and 200 N forces applied to the tibia at full extension in the intact PCL model, the maximum posterior tibial translations in the lateral compartment were 3.60 mm and 4.53 mm, coupled with tibial external rotation of 2.60° and 2.64°, respectively. The posterior tibial translation and tibial external rotation increase gradually with increasing knee flexion. The laxity responses of slight and medium PCL injury models were not noticeably different from those of the intact PCL model. In the severe PCL injury model, the external tibial rotation was noticeably decreased at 100 N, and was changed to internal rotation at 200 N. The PCL rupture caused obviously greater posterior tibial translation (6.77 mm and 9.68 mm under 100 N and 200 N drawer force, respectively) in the medial tibia, which, coupled with internal tibial rotation (-3.00° and -4.56° under 100 N and 200 N drawer force, respectively) at full extension. The posterior translation of the medial tibia and tibial internal rotation increased with increasing knee flexion. According to our study, the posterior drawer test does not necessarily indicate the existence of an isolated PCL injury, especially in partial cases. Furthermore, the magnitude of the loading affects the performance of mechanics in knees with PCL injuries, and internal tibial rotation is an important indication a knee with a PCL injury.

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“…In-vitro joint laxity has also been measured in cadaveric specimens with high accuracy (Darcy, et al, 2006;Pearsall, et al, 1996). Typically either load cells in combination with a linear variable differential transducer (LVDT) or a robotic system are used to apply anterior loads and measure the resulting displacement.…”

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confidence: 99%

A Novel Measure of In-Vivo Knee Joint Laxity

Küpper

Ronsky

Frayne

et al. 2007

ASME 2007 Summer Bioengineering Conference

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Current measures of knee joint laxity, such as those found clinically using the KT-2000 arthrometer, are not highly repeatable or reliable (Huber et al, 1997). In this study, a non invasive in-vivo Magnetic Resonance imaging-based measure of laxity, the Knee Loading Apparatus (KLA), was designed and evaluated with five normal subjects (repeatability study, n=3). Effects of total body water content, hormones, and muscle guarding were considered. When compared to the KT-2000, the KLA was found to be less variable iii Acknowledgements

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In Vitro Study of Knee Stability After Posterior Cruciate Ligament Reconstruction

Cited by 44 publications

References 35 publications

PCL reconstruction

PCL reconstruction

The effect of posterior cruciate ligament deficiency on knee laxity

A Novel Measure of In-Vivo Knee Joint Laxity

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