Partial Femoral Avulsion of the Posterior Cruciate Ligament Presenting as an Osteochondral Defect

Lee, Yong Seuk; Ahn, Jin Hwan; Park, Jung Ho; Park, Jong Woong; Yoon, Ji Yeol; Kum, Dong Ho

doi:10.1055/s-0030-1247778

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…Patients 1 through 3 (Table 1) may be considered to have massive peel off lesions. Our case is similar to that of Patient 4 [17] in that a partial osteochondral avulsion was observed and the osteochondral fragment was connected to a few fibers of the anterior portion of the PCL insertion (approximately 10% to 20% of the PCL insertion). However our case and that of Patient 4 involved different etiologies.…”

Section: Discussionsupporting

confidence: 81%

“…In contrast, only four cases of PCL avulsions of femoral origin have been reported in adults [8,17,22,23] (Table 1). Three of these patients were between 20 to 25 years old and one was 42; our patient was 22 years old.…”

Section: Discussionmentioning

confidence: 98%

“…We performed a comprehensive literature search and found most cases of avulsion of the PCL with femoral origin were reported in adolescents [6,14,15,19,21,27]. In contrast we found only four reported cases in adults [8,17,22,24]. Three of the four reported patients had complete avulsion of the PCL and the other had partial avulsion of the anterior bundle of the PCL.…”

Section: Introductionmentioning

confidence: 90%

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Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Chen

Shi

Jiang

2012

Clinical Orthopaedics &Amp; Related Research

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Background Injury of the PCL of the knee in adults usually results in rupture rather than avulsion fracture and avulsions usually occur at the tibial insertion. Case Description We report an avulsion of the PCL with a femoral origin in a 22-year-old man who was injured by hyperflexion of the knee and was treated with arthroscopy. There were two parts in the partial osteochondral avulsion fracture of the PCL posteromedial (PM) bundle. One part was fixed with polydioxanone suture through drill holes and the other was removed. The fracture healed after 3 months and the knee was stable. At 11 months postoperatively the patient had returned to full-time work without pain or restrictions. The Lysholm II knee score was 95 points. Physical examination showed a negative posterior drawer sign. Literature Review We identified four other reported cases of PCL femoral origin avulsion fractures in adults. The subjects were 20 to 25 years old in four of five reports, including our patient. Three of the five patients had involvement of only the lateral cortex of the medial femoral condyle whereas two other patients including our patient, had an osteochondral fracture. The mechanism of PCL avulsion seems to be similar to that of a PCL rupture. Purposes and Clinical Relevance The hyperflexion injury may result in injury of the PM bundle of the PCL. Our case and one other in the literature suggest such avulsions need not involve the entire PCL.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 90%

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Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Chen

Shi

Jiang

2012

Clinical Orthopaedics &Amp; Related Research

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“…In 2005, Park et al 7 reported a case of a 42-year-old man with an avulsion of PCL from its femoral attachment along with ACL avulsion from tibia. In 2009, Lee et al 8 reported a case of a 22-year-old soldier in which imaging had revealed bony fragments and an osteochondral defect in the medial femoral condyle which on arthroscopic evaluation was found to be originated from medial femoral condyle with a connection to the PCL fiber. In 2012, Xu et al 9 reported an avulsion of the PCL from femoral origin in a 22-year-old man.…”

Section: Discussionmentioning

confidence: 99%

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

Mishra

Vikas

2016

Medical Journal Armed Forces India

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“…Recently, soft-tissue grafts including 4-strand hamstring tendon and tibialis allografts have attracted increasing attention, and additional methods of graft fixation are being reported. [6][7][8][9] For the fixation of these soft-tissue grafts, suspensory and expansion mechanisms have some merits in terms of the length of the graft and stable fixation that is comparable to an already well-established technique. 6,10,11 Fixation using a suspensory or expansion mechanism has been introduced with the expectation of improving fixation stability and graft strength.…”

mentioning

confidence: 99%

Editorial Commentary: Biomechanics of Posterior Cruciate Ligament Tibial Fixation

Lee

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The surgical outcome of posterior cruciate ligament reconstruction is generally accepted as inferior to that of anterior cruciate ligament reconstruction. Numerous studies have reported causes of failure, and fixation stability would be one of the most important factors for a successful posterior cruciate ligament reconstruction. The fixation method, fixation area, graft construct, and effective length of the graft can all be consideration points. Strong fixation over a broad area that reduces the effective length of the graft and is composed of a multistranded graft would be the best.

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Partial Femoral Avulsion of the Posterior Cruciate Ligament Presenting as an Osteochondral Defect

Cited by 7 publications

References 5 publications

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

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

Editorial Commentary: Biomechanics of Posterior Cruciate Ligament Tibial Fixation

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