The Effect of Posterior Cruciate Ligament Injury and Reconstruction on Meniscal Strain

University of South Alabama, Mobile, Alabama, United States
The American Journal of Sports Medicine (Impact Factor: 4.36). 10/2004; 32(7):1675-80. DOI: 10.1177/0363546504265937
Source: PubMed


The relationship between posterior cruciate ligament insufficiency and meniscal injury is unclear.
Posterior cruciate ligament insufficiency results in increased medial and lateral meniscal strain.
Descriptive anatomic study.
Eight cadaveric specimens were evaluated with a 6-axis load cell and differential variable reluctance transducer strain gauges placed in both menisci. Data were recorded in the posterior cruciate ligament-intact state after posterior cruciate ligament transection and after posterior cruciate ligament reconstruction.
The effect of posterior cruciate ligament state on meniscal strain was more pronounced at higher flexion angles. At 60 degrees and 90 degrees of flexion, there was a significant effect of posterior cruciate ligament sectioning and reconstruction on meniscal strain (P < .026). Average meniscal strain for both medial and lateral menisci increased between the intact and the posterior cruciate ligament-cut states. Posterior cruciate ligament reconstruction decreased strain values to that of the intact knee.
Meniscal strain increases with complete posterior cruciate ligament injury and is returned to posterior cruciate ligament-intact levels after posterior cruciate ligament reconstruction. Clinical Relevance: Posterior cruciate ligament reconstruction may play an important role in reducing meniscal strain and subsequent degeneration within the posterior cruciate ligament-injured knee.

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    • "The clinical and biomechanical data on relationship between PCL injuries and menisci are scanty.111213 Pearsall et al. showed that meniscal strain increased with complete PCL injury and returned to normal after PCL reconstruction.14 Little is known about the biomechanical disorder in partial PCL transection cases and its impact on different parts of meniscal strain under various loading conditions. "
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    ABSTRACT: The relationship between medial meniscus tear and posterior cruciate ligament (PCL) injury has not been exactly explained. We studied to investigate the biomechanical effect of partial and complete PCL transection on different parts of medial meniscus at different flexion angles under static loading conditions. TWELVE FRESH HUMAN CADAVERIC KNEE SPECIMENS WERE DIVIDED INTO FOUR GROUPS: PCL intact (PCL-I), anterolateral bundle transection (ALB-T), posteromedial bundle transection (PMB-T) and PCL complete transection (PCL-T) group. Strain on the anterior horn, body part and posterior horn of medial meniscus were measured under different axial compressive tibial loads (200-800 N) at 0°, 30°, 60° and 90° knee flexion in each groups respectively. Compared with the PCL-I group, the PCL-T group had a higher strain on whole medial meniscus at 30°, 60° and 90° flexion in all loading conditions and at 0° flexion with 400, 600 and 800 N loads. In ALB-T group, strain on whole meniscus increased at 30°, 60° and 90° flexion under all loading conditions and at 0° flexion with 800 N only. PMB-T exihibited higher strain at 0° flexion with 400 N, 600 N and 800 N, while at 30° and 60° flexion with 800 N and at 90° flexion under all loading conditions. Partial PCL transection triggers strain concentration on medial meniscus and the effect is more pronounced with higher loading conditions at higher flexion angles.
    Indian Journal of Orthopaedics 09/2013; 47(5):493-9. DOI:10.4103/0019-5413.118206 · 0.64 Impact Factor
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    • "Short-term results of nonoperative treatment have been reported successful in many studies. However, there are studies showing unfavorable long-term results including degeneration of the tibiofemoral cartilage in the medial compartment and increased tibiofemoral pressure and meniscal strain25-27), which eventually led to arthritis. In the study of Dejour et al.28), osteoarthritis occurred eventually in the patients in whom the isolated rupture of the PCL was functionally well tolerated for 3 to 18 months. "
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    ABSTRACT: Posterior cruciate ligament (PCL) injuries associated with multiple ligament injuries can be easily diagnosed, but isolated PCL tears are less symptomatic, very difficult to diagnose, and frequently misdiagnosed. If a detailed investigation of the history of illness suggests a PCL injury, careful physical examinations including the posterior drawer test, dial test, varus and valgus test should be done especially if the patient complains of severe posterior knee pain in >90° of flexion. Vascular assessment and treatment should be done to avoid critical complications. An individualized treatment plan should be established after consideration of the type of tear, time after injury, associated collateral ligament injuries, bony alignment, and status of remnant. The rehabilitation should be carried out slower than that after anterior cruciate ligament reconstruction.
    09/2011; 23(3):135-41. DOI:10.5792/ksrr.2011.23.3.135
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    ABSTRACT: SUMMARY Surgical reconstruction of the knee posterior cruciate ligament (P.C.L.) still remains as a major therapeutic challenge. In this paper, we assessed 30 patients submitted to surgical reconstruction of the P.C.L. with a technique of tendinous graft fixation on tibial bed by direct approach ("INLAY"). Twenty- eight male patients and 2 female patients, with mean age of 31.10 years, participated on the study. The average injury time was 34.24 months. In 67% of the cases, injury was secondary to motorcycle accidents. Chondral injuries and knee anterior cruciate ligament (ACL) injuries were present in 67% and 33% of the cases, respectively. Patients were assessed objectively (posterior drawer test) and subjectively (Lysholm's Scale). Mean post-operative follow-up time was 21.7 months. About 66% of the cases were rated as good and excellent at the subjective and objective evaluation. The statistical analysis showed a similar behavior for both evaluations. Post-operative clinical outcomes achieved in this study have encouraged us to keep using this surgical technique.
    Acta Ortopédica Brasileira 12/2005; 14(2). · 0.19 Impact Factor
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