Isolated avulsion of the posterior cruciate ligament from the femoral attachment of the knee as a hyperextension injury is rare. We saw a young child with an incomplete avulsion of the posterior cruciate ligament that occurred after a blow to the anterior tibial surface of a flexed knee; the child revealed a lack of knee extension due to a pinch of the osteochondral fragment connected to the anterior band of the posterior cruciate ligament in the knee joint. Arthroscopic extirpation of a fragment was undertaken.
Tissue-type plasminogen activator (t-PA), tissue-type plasminogen activator inhibitor (t-PAI), and other factors (platelets, fibrinogen, fibrinogen degradation products, antithrombin-III, plasminogen, and α 2 -plasmin inhibitor [α 2 -PI]) related to the fibrinolytic system were studied in 21 patients undergoing total joint replacement.Seventeen of the 21 patients revealed an impaired fibrinolytic activity from the first to seventh postoperative day and a subsequent return to the preoperative level by the fourteenth postoperative day. There were accompanying increases in the level of α 2 -PI and in the t-PAI/t-PA ratio, and there was decrease in plasminogen level. Such hypofibrinolytic states may be related to a higher incidence of postoperative thrombosis in total joint replacement patients.
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