The Posterior Cruciate Ligament

Jc, Kennedy; Rw, Grainger

doi:10.1097/00005373-196705000-00004

Cited by 116 publications

(19 citation statements)

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“…3 in Table 1, the subluxation of the femur on the tibia at 60 ~ is not surprising, and is correlated with the difficulties that m a n y patients have with activities such as stair descent. The fact that the 98.05** *P < 0.05 vs. 0 ~ **P < 0.05 vs. 30 ~ most significant pressure changes in both absolute pressure value and pressure concentration occurred on the medial side at 60 ~ after cutting the PCL may provide laboratory evidence to support the observation of chronic degenerative changes on the medial compartment of the femoral condyle without PCL [2,5,11]. The reason for these changes is still not well understood.…”

Section: Discussionmentioning

confidence: 92%

A biomechanical analysis of joint contact forces in the posterior cruciate deficient knee

MacDonald

Miniaci

Fowler

et al. 1996

Knee Surg, Sports traumatol, Arthroscopy

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The approach to the posterior cruciate deficient knee is controversial. The purpose of this study is to document the biomechanical changes in the static cadaveric knee model with simulated physiological loads. Nine fresh cadaveric knees from young donors (aged under 45 years) were mounted on a materials testing machine. Loading was carried out at 0 degrees, 30 degrees and 60 degrees to 1.5 kN with low-pressure sensitive Prescale film (Fuji; Tokyo, Japan) inserted through arthrotomies into the medial and lateral compartments. Computerized analysis of the imprints on the film was then carried out. Tests were then repeated after cutting the posterior cruciate ligament (PCL). Results demonstrate a statistically significant posterior subluxation of the tibia on the femur at 60 degrees flexion. This causes a significant increase in contact pressure and pressure concentration on the medial compartment of the knee after cutting the PCL. This may help explain the long-term degenerative changes observed in the medial femoral condyle after cutting the PCL.

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Section: Discussionmentioning

confidence: 92%

A biomechanical analysis of joint contact forces in the posterior cruciate deficient knee

MacDonald

Miniaci

Fowler

et al. 1996

Knee Surg, Sports traumatol, Arthroscopy

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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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“…Kennedy & Grainger (1967), Hughston (1969) and Kennedy et al (1977) attribute the role of primary stabiliser of the knee to the posterior cruciate ligament. Balkfors (19821, however, found the disability resulting from posterior cruciate ligament injuries to be similar to that of other knee ligament injuries.…”

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confidence: 99%