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Posterior Cruciate Ligament Injuries: Rationale for Treatment

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Orthopedic Sports Medicine
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Abstract

Knee injuries are common and account for 15–50% of all sports injuries, 40% of which are ligamentous in nature [1]. Historically, the athletic population has been considered at risk for injuries involving the posterior cruciate ligament (PCL), but, interestingly, the reported incidence of these lesions is relatively low. However, PCL injuries are most likely underestimated due to the subtlety of their symptoms and physical exam findings. Although athletes can often function at a high level with an isolated PCL injury, combined injuries and severe isolated injuries with persistent symptomatic instability usually require surgical treatment. Indeed, isolated PCL injury, if left untreated, may result in disability years later, although the natural history of the PCL-deficient knee remains a matter of debate. Furthermore, clinical evidence that current reconstruction techniques significantly alter the stability and function of the PLC-deficient knee is lacking. This chapter provides an up-to-date overview of the basic science and clinical aspects of PCL injury, focusing on the athletic population.

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References

  1. Parolie JM, Bergfeld JA (1986) Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete. Am J Sports Med 14:35–38

    Article  PubMed  CAS  Google Scholar 

  2. Fanelli GC (1993) Posterior cruciate ligament injuries in trauma patients. Arthroscopy 9:291–294

    Article  PubMed  CAS  Google Scholar 

  3. Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15:553–557

    Article  PubMed  CAS  Google Scholar 

  4. Shino K, Horibe S, Nakata K et al (1995) Conservative treatment of isolated injuries to the posterior cruciate ligament in athletes. J Bone Joint Surg Br 77:895–900

    PubMed  CAS  Google Scholar 

  5. Cooper DE (1999) Clinical evaluation of posterior cruciate ligament injuries. Sports Med Arthrosc Rev 7:248–252

    Article  Google Scholar 

  6. Arendt E, Dick R (1995) Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med 23:694–701

    Article  PubMed  CAS  Google Scholar 

  7. Myklebust G, Maehlum S, Engebretsen L et al (1997) Registration of cruciate ligament injuries in Norwegian top level team handball: a prospective study covering two seasons. Scand J Med Sci Sports 7:289–292

    Article  PubMed  CAS  Google Scholar 

  8. Levy AS, Wetzler MJ, Lewars M et al (1997) Knee injuries in women collegiate rugby players. Am J Sports Med 25:360–362

    Article  PubMed  CAS  Google Scholar 

  9. Jarret GJ, Orwin JF, Dick RW (1998) Injuries in collegiate wrestling. Am J Sports Med 26:674–680

    PubMed  CAS  Google Scholar 

  10. Butler DL, Noyes FR, Grood ES (1980) Ligamentous restraints to anterior-posterior drawer in the human knee: a biomechanical study. J Bone Joint Surg Am 62:259–270

    PubMed  CAS  Google Scholar 

  11. Veltri DM, Deng XH, Torzilli PA et al (1995) The role of the cruciate and posterolateral ligaments in stability of the knee: a biomechanical study. Am J Sports Med 23:436–443

    Article  PubMed  CAS  Google Scholar 

  12. Grood ES, Stowers SF, Noyes FR (1988) Limits of movement in the human knee: effect of sectioning the posterior cruciate ligament and posterolateral structures. J Bone Joint Surg Am 70:88–97

    PubMed  CAS  Google Scholar 

  13. Covey DC, Sapega AA (1994) Anatomy and function of the posterior cruciate ligament. Clin Sports Med 13:509–518

    PubMed  CAS  Google Scholar 

  14. Kennedy JC, Hawkins RJ, Willis RB et al (1976) Tension studies of human knee ligaments: yield point, ultimate failure, and disruption of the cruciate and tibial collateral ligaments. J Bone Joint Surg Am 58:350–355

    PubMed  CAS  Google Scholar 

  15. Prietto MP, Bain JR, Stonebrook SN et al (1988) Tensile strength of the human posterior cruciate ligament (PCL) [abstract]. Trans Orthop Res Soc 13:195

    Google Scholar 

  16. Harner CD, Xerogeanes JW, Livesay GA et al (1995) The human posterior cruciate ligament complex: an interdisciplinary study: ligament morphology and biomechanical evaluation. Am J Sports Med 23:736–745

    Article  PubMed  CAS  Google Scholar 

  17. Gollehon DL, Torzilli PA, Warren RF (1987) The role of the posterolateral and cruciate ligaments in the stability of the human knee: a biomechanical study. J Bone Joint Surg Am 69:233–242

    PubMed  CAS  Google Scholar 

  18. Harner CD, Janaushek MA, Ma CB et al (2000) The effect of knee flexion angle and application of an anterior tibial load at the time of graft fixation on the biomechanics of a posterior cruciate ligament-reconstructed knee. Am J Sports Med 28:460–5-3

    PubMed  CAS  Google Scholar 

  19. Nielsen S, Helmig P (1984) The static stablilizing function of the popliteal tendon in the knee. Arch Orthop Trauma Surg 103:165–169

    Article  PubMed  CAS  Google Scholar 

  20. Neilsen S, Helmig P (1986) Posterior instability of the knee joint: an experimental study. Arch Orthop Trauma Surg 105:121–125

    Article  Google Scholar 

  21. Neilsen S, Ovesen J, Rasmussen O (1985) The posterior cruciate ligament and rotatory knee instability. Arch Orthop Trauma Surg 104:53–56

    Article  Google Scholar 

  22. Vogrin TM, Hoher J, Aroen A et al (2000) Effects of sectioning the posterolateral structures on knee kinematics and in situ forces in the posterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 8:93–98

    Article  PubMed  CAS  Google Scholar 

  23. Clancy Jr WG, Shelbourne KD, Zoellner GB et al (1983) Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament: report of a new procedure. J Bone Joint Surg Am 65:310–322

    PubMed  Google Scholar 

  24. Harner CD, Janaushek MA, Kanamori A et al (2000) Biomechanical analysis of a doublebundle posterior cruciate ligament reconstruction. Am J Sports Med 28:144–151

    PubMed  CAS  Google Scholar 

  25. Berg EE (1999) Posterior cruciate ligament recession. Arthroscopy 15:644–647

    Article  PubMed  CAS  Google Scholar 

  26. Berg EE (1995) Posterior cruciate ligament tibial inlay reconstruction. Arthroscopy 11:69–76

    Article  PubMed  CAS  Google Scholar 

  27. Margheritini F, Mauro CS, Rihn JA et al (2004) Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: analysis of knee kinematics and graft in situ forces. Am J Sports Med 32:587–593

    Article  PubMed  Google Scholar 

  28. MacGillivray JD, Stein BE, Park M et al (2006) Comparison of tibial inlay versus transtibial techniques for isolated posterior cruciate ligament reconstruction: minimum 2-year followup. Arthroscopy 22(3):320–328

    Article  PubMed  Google Scholar 

  29. Fanelli GC, Edson CJ (1995) Posterior cruciate ligament injuries in trauma patients: part II. Arthroscopy 11:526–597

    Article  PubMed  CAS  Google Scholar 

  30. Wascher DC, Grauer JD, Markoff KL (1993) Biceps tendon tenodesis for posterolateral instability of the knee: an in vitro study. Am J Sports Med 21:400–406

    Article  PubMed  CAS  Google Scholar 

  31. Harner CD, Vogrin TM, Hoher J et al (2000) Biomechanical analysis of a posterior cruciate ligament reconstruction: deficiency of the posterolateral structures as a cause of graft failure. Am J Sports Med 28:32–39

    PubMed  CAS  Google Scholar 

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Margheritini, F., Rossi, R., Frascari, F., Mariani, P.P. (2011). Posterior Cruciate Ligament Injuries: Rationale for Treatment. In: Margheritini, F., Rossi, R. (eds) Orthopedic Sports Medicine. Springer, Milano. https://doi.org/10.1007/978-88-470-1702-3_28

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  • DOI: https://doi.org/10.1007/978-88-470-1702-3_28

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1701-6

  • Online ISBN: 978-88-470-1702-3

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