The effect of posterior cruciate ligament injury and reconstruction on meniscal strain
ABSTRACT 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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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: 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 · 0.62 Impact Factor
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ABSTRACT: Posterior cruciate ligament injuries are increasingly recognized, the result of various sports activities, and while most athletes return to sports the development degenerative joint changes is common. To provide a synopsis of the current best evidence regarding the recognition and treatment of posterior cruciate ligament injuries. Structured narrative review. Keyword search of Medline, CINAHL, and PEDro databases for studies published in English from January 1975 to July 2011. Additionally, the reference lists from articles obtained were manually searched for relevant literature. The manuscript provides an overview of posterior cruciate ligament injury, discusses diagnostic methods to include radiographic examination techniques, and presents information on surgical and conservative management of PCL injuries. Understanding the mechanism of injuries and most effective examination methods can aide in effective early recognition of PCL injuries. Appropriate management of the patient with PCL deficiency or reconstructed knee will optimize outcomes and potentially affect long term knee function.Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine 11/2012; 13(4):196-208. DOI:10.1016/j.ptsp.2012.03.016 · 1.37 Impact Factor