Evaluation of healing of the injured posterior cruciate ligament: Analysis of instability and magnetic resonance imaging

被引:30
作者
Akisue, T [1 ]
Kurosaka, M [1 ]
Yoshiya, S [1 ]
Kuroda, R [1 ]
Mizuno, K [1 ]
机构
[1] Kobe Univ, Sch Med, Dept Orthopaed Surg, Chuo Ku, Kobe, Hyogo 6500017, Japan
来源
ARTHROSCOPY | 2001年 / 17卷 / 03期
关键词
ligament; posterior cruciate ligament; knee; instability; magnetic resonance imaging;
D O I
10.1053/jars.2001.21540
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: Knees with an acute posterior cruciate ligament (PCL) injury and soft endpoint on posterior drawer test often develop less instability and a firm endpoint at later follow-up. This type of healing is rarely seen in the acutely injured anterior cruciate ligament (ACL) and seems to be a. unique feature of healing fur PCL injury. The purpose of this study was to explore the healing process of the injured by means of instability measurement and magnetic resonance imaging (MRI). Type of study: Consecutive sample. Methods: Forty-eight acute PCL deficient knees were followed up and evaluated. We evaluated the detection of a so-called firm endpoint using a posterior drawer test. We also determined the degree of posterior sag and categorized them as 3 grades. Quantitative assessment of total anteroposterior (AP) translation of the tibia with a KT-1000 knee arthrometer (MedMetric, San Diego, California) was performed by manual maximum AP drawer test with the knee flexed 700. The continuity of the PCL was evaluated with sagittal and coronal T1- and T2-weighted MRIs. Results: Thirty-three (69%) cases exhibited a so-called firm endpoint with a posterior drawer test. These cases showed statistically less total AP translation (mean, 7.0 mm) in KT-1000 evaluation, compared with 15 cases without an endpoint (mean, 11.9 mm). In addition, 36 cases (75%) with continuous low-intensity MRI showed statistically less AP translation (mean 7.6 mm), compared with 12 cases (mean 11.4 mm) with disrupted PCL image. Conclusions: These results suggest that a high percentage of acutely injured PCLs are likely to develop somewhat slack but continuous ligament-like tissue, and this continuous PCL-like tissue might function as a posterior restraint of the tibia to certain extent. The elongated but continuous PCL might paltry explain the relatively favorable prognosis of this injury.
引用
收藏
页码:264 / 269
页数:6
相关论文
共 29 条
[1]
ANDREWS JR, 1994, CLIN SPORT MED, V13, P519
[2]
BERGER RS, 1993, KNEE FORM FUNCTION P, P565
[3]
Long-term followup of the untreated isolated posterior cruciate ligament-deficient knee [J].
Boynton, MD ;
Tietjens, BR .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1996, 24 (03) :306-310
[4]
TREATMENT OF KNEE-JOINT INSTABILITY SECONDARY TO RUPTURE OF THE POSTERIOR CRUCIATE LIGAMENT - REPORT OF A NEW PROCEDURE [J].
CLANCY, WG ;
SHELBOURNE, KD ;
ZOELLNER, GB ;
KEENE, JS ;
REIDER, B ;
ROSENBERG, TD .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1983, 65 (03) :310-322
[5]
CLANCY WG, 1994, CLIN SPORT MED, V13, P629
[6]
CURRENT CONCEPTS REVIEW - INJURIES OF THE POSTERIOR CRUCIATE LIGAMENT [J].
COVEY, DC ;
SAPEGA, AA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1993, 75A (09) :1376-1386
[7]
LONG-TERM FOLLOW-UP OF POSTERIOR CRUCIATE LIGAMENT RUPTURE - A STUDY OF 116 CASES [J].
CROSS, MJ ;
POWELL, JF .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1984, 12 (04) :292-297
[8]
THE LONG-TERM RESULTS OF UN-REPAIRED TEARS OF THE POSTERIOR CRUCIATE LIGAMENT [J].
DANDY, DJ ;
PUSEY, RJ .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1982, 64 (01) :92-94
[9]
DANIEL DM, 1990, KNEE LIGAMENTS STRUC, P427
[10]
POSTERIOR CRUCIATE LIGAMENT INJURIES IN TRAUMA PATIENTS [J].
FANELLI, GC .
ARTHROSCOPY, 1993, 9 (03) :291-294