• Title/Summary/Keyword: posterior cruciate ligament (PCL)

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Anatomy and Biomechanics of the Posterior Cruciate Ligament (후방 십자 인대의 해부학과 생역학)

  • Kim, Hyoung-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.4-14
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    • 1998
  • As with anterior cruciate ligament reconstruction, posterior cruciate ligament(PCL) reconstruction requires a good understanding of the anatomy and biomechanical properties of the PCL to place the graft correctly as well as to choose the appropriate structure and material for the graft. The anatomy and function of the PCL can be somewhat confusing and continuing to evolve so far. Recent studies have focused on the insertion site anatomy and the identification of the functional components of the ligament. The issue of the ligament isometry and the role of PCL in knee kinematics are still totally resolved. This article can be provided an update on current concepts of the anatomy and biomechanics of the PCL through literature reviews. A clear understanding of these knowledges enables the clinicians to diagnose injuries to the PCL accurately and to reconstruct these structures successfully.

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Initial Lengthening Behavior of Cadaveric Achilles Tendon Graft After Posterior Cruciate Ligament Reconstruction (후방십자인대 재건술 후 사체 아킬레스 이식건의 초기연신거동)

  • Kim, Cheol-Woong;Bae, Ji-Hoon;Lee, Ho-Sang;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1461-1466
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    • 2008
  • In the case of Posterior Cruciate Ligament (PCL), the most frequent mechanism is the dashboard injury, which is directly pressurized to the anterior of the proximal tibia in the state of the knee hyperflexion. The PCL associated ligament damage happens when the posterior injury, the varus, the valgus, the hyperextension and the severe vagus torque are out of the critical value of PCL. After the successful operation cases of Anterior Cruciate Ligament (ACL) reconstruction using the allograft were informed from 1986, a number of results kept over the maximum 10 years were reported. Unfortunately, PCL reconstruction are crowded the surgery techniques such as the graft, the tibia fixing method, the fixation device, the location of the femoral tunnel, the number of the graft bundles and PCL reconstruction to access to the stability of the normal joint is being developed. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The initial extension of the Achilles tendon by the fixing device and its location under the cyclic loading, were observed.

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Slippage Behavior Due to the Calcaneus Fixation and Achilles Tendon Soft Tissue in Posterior Cruciate Ligament (PCL) Reconstruction (PCL 재건술용 아킬레스 이식건의 종골편 고정법과 연부조직 고정법에 따른 활주거동)

  • Kim, Cheol-Woong;Lee, Ho-Sang;Bae, Ji-Hoon;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1527-1532
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    • 2008
  • 45% of the sports accidents is the knee damage and the representative case is the damage of an Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament(PCL). Although the past different views of ACL reconstruction comes to an agreement, the disputes of PCL is remained yet. The most important engineering approach for these various surgery techniques is accurately to understand and to evaluate the fatigue behavior depending on the stress flow and the stress distribution under the allotted load and the cyclic load, which are caused by the graft fixing device, the proximal tibia of the PCL reconstructing structure. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The relationships between the slippage, the extension ratio, and the slippage ratio by the heel bone fixing method and the soft tissue fixing method of the Achilles tendon were also defined. This research will be the essential data to help the resonable operating techniques for the next PCL reconstruction.

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Arthroscopic Treatment of the Ganglion Cysts of the Posterior Cruciate Ligament Through the Anteromedial Portal (전내측 도달법을 이용한 후방 십자 인대 결절종의 관절경적 치료)

  • Choi, Joong-Geun
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.68-71
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    • 1998
  • Ganglion cysts of the cruciate ligaments of the knee are rare and their pathogenesis is uncertain. A few cases of the cyst of the posterior cruciate ligament were reported in the literature. We have arthroscopically treated sucessfully the ganglion cysts of the posterior cruciate ligament through the anteromedial portal. We reported three cases of ganglion cyst of the posterior cruciate ligament with brief of literatures.

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Comparing Changes in Knee Muscle Strength after Reconstruction of the Anterior and Posterior Cruciate Ligaments

  • Hyun, SangWook;Kim, SoHee;Kim, TaeHo
    • The Journal of Korean Physical Therapy
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    • v.31 no.6
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    • pp.339-345
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    • 2019
  • Purpose: The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors.

Bone Microarchitecture at the Femoral Attachment of the Posterior Cruciate Ligament (PCL) by Texture Analysis of Magnetic Resonance Imaging (MRI) in Patients with PCL Injury: an Indirect Reflection of Ligament Integrity

  • Kim, Hwan;Shin, YiRang;Kim, Sung-Hwan;Lee, Young Han
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.2
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    • pp.93-100
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    • 2021
  • Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.

Open Posterior Approach versus Arthroscopic Suture Fixation for Displaced Posterior Cruciate Ligament Avulsion Fractures: Systematic Review

  • Song, Jae-Gwang;Nha, Kyung-Wook;Lee, Se-Won
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.275-283
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    • 2018
  • Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures. Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow-up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points. Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12-month follow-up, and 174 patients underwent arthroscopic suture fixation. At final follow-up, the range of Lysholm score was 85-100 for the open approach and 80-100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%-100% for the open approach and 90%-100% for the arthroscopic approach. The range of side-to-side difference was 0-5 mm for both approaches. Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial-side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.

A study on modelling for ACL and PCL using various strain energy functions (다양한 변형률 에너지 함수를 사용한 전방 및 후방 십자 인대의 모델링에 관한 연구)

  • Lim, Jun-Taek;Choi, Deok-Kee;Kim, Young-En
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.658-663
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    • 2008
  • The mechanical study on the anterior and posterior cruciate ligament(ACL, PCL) is of importance because the recent increase of outdoor and indoor activities is directly related to causing sport injuries on the knee joints. Constitutive models for many biological tissues have been known as hyperelasticitic models. The elastic behavior of ACL and PCL may be described by the free energy function which accounts for the matrix and the collagen fibers. This paper addresses a comparison of different types of the free energy function to the existing results.

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Radiofrequency Shrinkage Method for Minor Degree of Cruciate Ligament Injury of knee joint (경도의 슬관절 십자 인대 손상환자에 대하여 시행한 열 위축술)

  • Moon Young Lae;Ha Sang Ho;You Jae Won;Joo Jeong Yong;Ju Pyong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.37-42
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    • 2002
  • Purpose : To report a short-term clinical results and technical method of thermal shrinkage with radiofrequency device for anterior and posterior cruciate ligament laxity which is not suitable to indications of reconstructive surgery. Materials and Methods : Nine cases of anterior cruciate ligament injuries (ACL), 5 cases of posterior cruciate ligament (PCL) injuries and 3 cases of combined anterior and posterior cruciate ligament injuries, in which the condition is not indicated as reconstructive surgery, are investigated. The follow-up period averaged 6 months. Results : Instability in living activity, limping and pain were improved with excellent results. But, posterior cruciate ligament thermal shrinkage revealed as recurrent knee laxity progressively Conclusions : The result of thermal shrinkage for partial tear of cruciated ligament was excellent. We believe this procedure is applicable to partial tear of the ACL or PCL which reconstructive surgery is not indicated. Long-term follow-up results were needed.

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