The role of isolated posterior cruciate ligament reconstruction in knees with combined posterior cruciate ligament and posterolateral complex injury

Lee, Dong-Yeong; Park, Youngjin; Kim, Dong‐Hee; Kim, Hyun-Jung; Nam, Dae-Cheol; Park, Jin-Sung; Hwang, Sun‐Chul

doi:10.1007/s00167-017-4672-x

Cited by 18 publications

(20 citation statements)

References 29 publications

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“…Similar to our results, Sanders et al . reported, that 88.5% (54/61) of patients had grade 0 varus laxity at 30° of knee flexion, 9.8% (6/61) had grade I laxity, and 1.7% (1/61) had grade II laxity. In another study, by Yoon et al ,.…”

Section: Discussionmentioning

confidence: 99%

“…reported, that 88.5% (54/61) of patients had grade 0 varus laxity at 30° of knee flexion, 9.8% (6/61) had grade I laxity, and 1.7% (1/61) had grade II laxity. In another study, by Yoon et al ,. using anatomical PLC reconstruction, the varus and posterior stress radiograph showed a significant decrease to 0.9 mm and 5.3 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries which typically occur secondary to a forced varus moment or after knee dislocation are among the most refractory conditions in the sports medicine clinic, because not only is the optimal treatment controversial and individualized, including the timing of surgery, repair versus reconstruction, autograft versus allograft reconstruction, postoperative rehabilitation protocols, and the indications for a tibial or femoral osteotomy, but also the diagnosis and postoperative evaluation require comprehensive and meticulous physical examinations, including the dial test, the reverse pivot‐shift test, the external rotational recurvatum test, and the posterolateral drawer test. Furthermore, these subjective evaluations rely on subtleties in the physical examinations, especially when facing concurrent multi‐ligament injuries.…”

Section: Introductionmentioning

confidence: 99%

“…The PCL is a primary restraint to posterior tibial translation at all flexion angles. It also has a role in primary restraint for internal rotation and external tibial rotation beyond 90° of flexion. We classified the side‐to‐side difference in posterior tibial translation into: Grade 1, 0–5 mm of side‐to‐side difference in posterior displacement constitutes a partial PCL tear; Grade 2, 6–10 mm; and Grade 3, >10 mm of posterior translation.…”

Section: Introductionmentioning

confidence: 99%

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Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation

Hong

Xuesong

et al. 2019

Orthopaedic Surgery

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Objectives The arthroscopic “lateral gutter drive‐through” (LGDT) sign is reported to diagnose popliteus tendon (PT) injury with high sensitivity and specificity. However, no study has provided a postoperative evaluation of combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries using the LGDT test. Methods From January 2012 to January 2015, a total of 80 consecutive patients who underwent combined PCL reconstruction and PLC surgeries were identified. Fifty eligible patients were included in this study for evaluation with subjective scoring systems, physical examinations, posterior and varus stress radiographs, and second‐look arthroscopic surgeries during hardware removal operation. Results Forty‐nine patients were available for a mean of 31.5 ± 9.3 months follow‐up (range, 24.0–81.0 months). In terms of PLC injury pattern, there were 27 type A, 10 type B, and 12 type C patients, with 21 acute cases and 28 chronic cases. At the final follow‐up, subjective scores were all significantly improved. The side‐to‐side difference (SSD) of posterior tibial translation (PTT) improved from 18.4 ± 9.2 mm (range, 12.9–25.6 mm) to 5.2 ± 5.0 mm (range, −5.0−18.5 mm, P < 0.001), and the SSD of tibial external rotation by dial test (ER) decreased from 18.0° ± 14.4° (range, 13.0°–22.0°) to 1.2° ± 7.5° (range, −9.0°–22.0°, P < 0.001). In patients with type C injury, the SSD of the lateral opening decreased from 14.2 ± 6.6 mm (range, 22–10.2 mm) to 0.9 ± 3.1 mm (range, −4.4‐6 mm, P < 0.001). In a comparison between patients with positive and negative LGDT signs, the LGDT‐negative patients had significant superiority in subjective scores, SSD of PTT, and SSD of ER. The sensitivity and specificity of the LGDT test in detecting postoperative posterolateral rotational instability (PLRI) were calculated as 100% and 88.4%, respectively. Conclusions In the series of surgically treated patients with PCL and PLC injury: (i) patients had improved subjective and objective clinical outcome after combined PCL reconstruction and PLC surgery at a minimum of 24‐months follow‐up; and (ii) second arthroscopic LGDT sign testing had high sensitivity and specificity in detecting postoperative PLRI, and a positive LGDT sign was related with inferior subjective and objective results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation

Hong

Xuesong

et al. 2019

Orthopaedic Surgery

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“…A large number of scientific studies tackle the development and research of various methods for restoring the stability of the knee joint [3][4][5]. For example, [4] considers a technique of restoring the ligamentous apparatus, with combined injuries to the knee joint but only the posterior cruciate ligament is reconstructed.…”

Section: Literature Review and Problem Statementmentioning

confidence: 99%

Influence of the fixation point of the artificial popliteal muscle graft on the stability of the knee joint under external rotational load

Panchenko

Holovakha

Kolosov

et al. 2022

EEJET

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This paper investigated the dependence of the stability of the knee joint, when exposed to external rotational load on the lower leg, on the position of the graft of the tendon of the popliteal muscle. Estimation finite-element models of the right knee joint of an adult were constructed, which included the articular ends of the bones that form this joint, as well as its main ligaments. The models reflected a surgery to restore posterolateral angle structures and differed only in the position of the popliteal tendon graft. That position was set by the point of attachment of the graft to the posterior surface of the tibia. At the same time, the fixation point changed both vertically and horizontally, in the frontal plane. In addition, a control model was built in which the hamstring tendon was completely absent. As a result of the calculations, patterns of the distribution of the fields of movement of the points of the finite-element model were obtained. As criteria for assessing the effectiveness of the selected position of the graft, movements of the lower leg model in the horizontal plane were proposed. Analysis of the results of the calculations showed that the greatest movements in all directions were obtained in the control model, in which the hamstring of the popliteal muscle was absent. The magnitudes of the considered movements derived from the control model exceeded the same values in the model with minimal movements by 17, 37, 17, 32, and 16 %. From the point of view of the stability of the tibia under rotational load, the most effective was the fixation of the graft on the posterior surface of the tibia as laterally as possible and closer to its articular surface. This is indicated by the magnitude of the movements, which, in this case, turned out to be the smallest in all directions.

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Posterior Cruciate Ligament Injuries

Fortier,

Dasari,

Mameri

et al. 2024

Orthopaedic Sports Medicine

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The role of isolated posterior cruciate ligament reconstruction in knees with combined posterior cruciate ligament and posterolateral complex injury

Cited by 18 publications

References 29 publications

Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation

Midterm Clinical Outcome of Combined Posterior Cruciate Ligament Reconstruction and Posterolateral Corner Surgery Using Second‐Look Arthroscopic “Lateral Gutter Drive‐Through” Test as an Adjunctive Evaluation

Influence of the fixation point of the artificial popliteal muscle graft on the stability of the knee joint under external rotational load

Posterior Cruciate Ligament Injuries

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