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At least 307 records · Page 17Linked to original sources
PubMed1998

[Combined anterior cruciate ligament and posterior cruciate ligament injury--technique and results of simultaneous arthroscopic reconstruction].

Simultaneous ACL and PCL ruptures are rare but serious injuries resulting in distinct instability of the knee joint followed by an early degenerative arthritis. This combined trauma, which is often accompanied by additional ligament lesions, originates from a knee dislocation. While the conservative treatment of this complex instability is abandoned, the operative procedures are not yet standardised. The timing of the cruciate ligament reconstruction depends on the additional injuries, but generally the postprimary treatment is performed. Autografts and allografts, which can be also combined, are available for the reconstruction of the cruciate ligaments. The arthroscopic assisted operation starts with the drilling of all tibial and femoral tunnels using standard ACL and PCL arthroscopic instruments. The PCL is positioned after the graft has been transported into the joint through an anterolateral port, the ACL graft is positioned through the tibial drill hole and both are anchored first on the femoral and then on the tibial site i.e. with interference screws. In the postoperative rehabilitation neither immobilisation nor brace are used and progressive range of motion is allowed. The arthroscopic assisted reconstructions of the ACL and increasingly of the PCL are becoming standard procedures, but the technically difficult combined ACL/PCL reconstruction is restricted to a small number of arthroscopists. The first clinical results demonstrate, that the arthroscopic operation is comparable to the open reconstruction.

Anterior Cruciate Ligament↗
PubMed1995

Stability and range of motion of Insall-Burstein condylar prostheses. A computer simulation study.

The Insall-Burstein Posterior Stabilized Prosthesis (Zimmer, Warsaw, IN) uses an articulation between a femoral cam and tibial spine to provide anteroposterior stability to the knee. Dislocation can occur if the femoral cam translocates anteriorly and over the tibial spine. A computer model was used to examine the effects of design changes made between the Insall-Burstein I (IB I), Insall-Burstein II (IB II), and revised Insall-Burstein II (IB IIR) knees. The effects of these design changes were determined from their influence on knee stability and maximum obtainable knee flexion. Knee stability was characterized by a dislocation safety factor, defined as the vertical distance from the top of the tibial spine to the bottom of the femoral cam. Our analysis showed that the dislocation safety factor is greatest at approximately 70 degrees of knee flexion for all IB knees. As knee flexion is increased from this angle, the dislocation safety factor decreases, reducing knee stability. The simulations highlighted a trade-off between improving knee flexion and improving knee stability. The geometry of the IB II knee allowed greater knee flexion. The maximum flexion achieved with the IB II knee was 125 degrees compared with 115 degrees and 117 degrees for the IB I and IB IIR knees, respectively. However, the simulations indicate that the IB I and IB IIR knees are less likely to dislocate because they have greater dislocation safety factors than the IB II knees.

Biomechanical Phenomena↗
PubMed2002

[Congenital dislocation of the knee in children--unusual condition of unknown etiology].

Congenital dislocation of the knee is a rare condition. It results in an inability to flex the knee. The condition is normally diagnosed clinically during the neonatal period and is verified by X-ray and/or ultrasound. Treatment is preferably non-operative with gradually increased passive flexion of the knee. In certain cases surgery may be justified. In a majority of cases, the children achieve acceptable knee-function after treatment. In the region of Sundsvall-Härnösand in Sweden, during the past seven years five children with congenital dislocation of the knee were born, which is a considerable accumulation of cases. This article describes these five children, their condition, possible etiology and strategies of treatment.

Child↗
PubMed2004

Posterolateral dislocation of the knee joints: analysis of 9 cases.

OBJECTIVE: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment. METHODS: Nine cases of posterolateral dislocation of knee joint, 5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial joint, among them 3 cases underwent repair of the damaged ligaments. In the old injury group 2 cases underwent ACL and MCL repair only in acute stage, but re-dislocated. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted fracture of the tibial condyle and popliteal artery injury. Open reduction was performed in 3 cases. One case was fixed with 2-crossed pin and another was fixed with one pin through the tibial and femoral condyle and second pin with olecranization fixation. Plaster immobilization for 6-8 weeks respectively was required. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery injury. RESULTS: All the cases were followed up for 1-23 years (average 6 years). Knee stability in 4 cases with repair of the ligaments was improved, although PDT showed (+) with different degrees. The results of the patients treated with ligamentous reconstruction were much better than those of the patients without any repair. CONCLUSIONS: Well understanding of the traumatic pathological characteristics, repair of the damaged ligaments, augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of successful treatment.

Adolescent↗