Radiographic study on the tibial insertion of the posterior cruciate ligament

Gali, Julio Cesar; Esquerdo, Paulo; Almagro, Marco Antonio Pires; Silva, Phelipe Augusto Cintra da

doi:10.1016/j.rboe.2015.04.003

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Much of the literature has focused on biomechanical and functional outcomes when comparing various PCLR techniques. 7,12,22,31,41,48 However, there is a growing body of information regarding patient function following isolated PCLR, including whether patients can expect RTS following surgery. The aim of this study was to systematically review and synthesize the literature to determine the functional outcome and rate of RTS and activity following isolated PCLR.…”

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confidence: 99%

Isolated Posterior Cruciate Reconstruction Results in Improved Functional Outcome but Low Rates of Return to Preinjury Level of Sport: A Systematic Review and Meta-analysis

Devitt

Dissanayake

Clair

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Although isolated posterior cruciate ligament reconstruction (PCLR) has become a more frequently performed procedure, reports of functional outcomes and return-to-sport (RTS) rates to support its use are still limited.Purpose:To systematically review the literature to determine the rates of RTS and the functional outcomes of patients after isolated PCLR.Study Design:Systematic review: Level of evidence, 4.Methods:Two reviewers independently searched 5 databases for patient-based clinical studies with a minimum 2-year follow-up that analyzed functional outcome and RTS following isolated PCLR. Studies with multiligament knee reconstruction were excluded. Risk of bias was performed with a modified Downs and Black checklist. The primary outcomes were Tegner and Lysholm scores, rates of RTS, and International Knee Documentation Committee (IKDC) subjective scores. Secondary outcomes were IKDC objective scores, instrumented knee laxity assessment, and Telos radiographic analysis. Where feasible, these data were pooled via a random effects meta-analysis model.Results:Of the 240 titles identified, 14 studies were included. The median time from injury to surgery was 10.6 months (range, 6 weeks–21 years). The pooled mean postoperative Tegner and Lysholm scores were 5.7 (95% CI, 5.4-6.0) and 87.8 (95% CI, 85.6-90.0), respectively, following isolated PCLR; the pooled effect size between pre- and postoperative values was 2.8 (95% CI, 1.6-4.0) and 3.7 (95% CI, 2.6-4.9), respectively. An RTS rate of 44% (95% CI, 23%-66%) was identified. IKDC subjective scores improved to a pooled mean of 73.5 (95% CI, 62.8-84.1), with an effect size of 3.0 (95% CI, 0.4-5.6). The proportion of patients with postoperative IKDC objective scores of grade A/B was 82%. The pooled postoperative KT-1000/KT-2000 side-to-side difference was 3.4 mm (95% CI, 2.5-4.3 mm), with an effect size of 2.8 (95% CI, 1.1-4.5). The pooled postoperative Telos side-to-side difference measurement was 3.5 mm (95% CI, 2.8-4.3 mm), with an effect size of 3.9 (95% CI, 3.3-4.5).Conclusion:The results of this review demonstrate that while isolated PCLR results in a significant improvement in functional outcome scores and improved knee laxity, there is a low rate of return to preinjury level of sport. The prolonged period from injury to surgery might reduce functional improvement and RTS following reconstruction. Therefore, comparison of the outcomes of isolated PCLR and nonoperative treatment is impracticable owing to the potential for selection bias.

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confidence: 99%

Isolated Posterior Cruciate Reconstruction Results in Improved Functional Outcome but Low Rates of Return to Preinjury Level of Sport: A Systematic Review and Meta-analysis

Devitt

Dissanayake

Clair

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…In order to obtain more reliable anatomical information regarding PCL, multiple researchers reported various methods. Gali and colleagues reported that the PCL bundle's tibial insertions can be identified and marked using metal tags, prior to knee radiography 23 . Van Hoof T reported that a contrast medium injected before computed tomography (CT) imaging of the knee can segment and render in 3D imaging, thus, facilitating morphological and morphometric analysis of the PCL 24 .…”

Section: Discussionmentioning

confidence: 99%

Application of CT‐MRI Fusion‐Based Three‐Dimensional Reconstruction Technique in the Anatomic Study of Posterior Cruciate Ligament

Feng

Wang

Jin

et al. 2022

Orthopaedic Surgery

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Objective During PCL reconstruction surgery, precise and personalized positioning of the graft tunnel is very important. In order to obtain patient‐specific anatomical data, we established a three‐dimensional knee joint fusion model to provide a unified imaging strategy, as well as anatomical information, for individualized and accurate posterior cruciate ligament (PCL) reconstruction. Methods This is an exploration study. From January 2019 to January 2020, 20 healthy adults randomly were enrolled and assessed via CT and MRI imaging. A three‐dimensional fusion model of the knee joint was generated using the modified MIMIMICS and image fusion software. On the fused image, the areas of the femoral and tibial PCL footprint of both knees were measured. The anatomical center of the PCL footprint was measured at the femoral and tibial ends. The relevant bony landmarks surrounding the PCL femoral and tibial attachment were also measured. Paired t‐tests were employed for all statistical analyzes, and p < 0.05 was considered as statistically significant. Results All 20 subjects achieved successful image fusion modeling and measurement, with an average duration of 12 h. The lengths of the LF1‐LF3 were 32.1 ± 1.8, 6.8 ± 2.5, and 23.3 ± 2.1 mm, respectively. The lengths of the LT1‐LT3 were 37.3 ± 3.3, 45.6 ± 5.3, and 6.0 ± 1.2 mm, respectively. The distances between the tibial PCL center of the left knee to the medial groove, champagne‐glass drop‐off, and the apex of the medial intercondylar were 8.4 ± 2.4, 9.2 ± 1.8, and 15.3 ± 1.4 mm, respectively, and the corresponding distances from the right knee were 8.0 ± 2.0, 9.4 ± 2.2, and 16.1 ± 1.8 mm, respectively. We observed no difference between the bilateral sides, in terms of the distance from the PCL center to the PCL attachment‐related landmark, under arthroscopic guidance. The area of the femoral and tibial PCL footprints on the left knee were 115.3 ± 33.5 and 146.6 ± 24.4 mm2, respectively, and the corresponding areas on the right knee were 121.8 ± 35.6 and 142.8 ± 19.5 mm2, respectively. There was no difference between the bilateral sides in terms of the PCL footprint areas. Conclusion In the fusion image, the PCL attachment center and relevant bony landmarks which can be easily identified under arthroscopy can be accurately measured. The model can also obtain personalized anatomical data of the PCL on the unaffected side of the patient, which can guide clinical PCL reconstruction.

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“…Hence, variability of the PCL laxity exists among normal subjects. In addition, cadaveric studies have revealed a wide variation of attachment site and course of fiber for the PCL ( 16 19 20 21 ). Depending on the variability of the physiologic laxity and anatomical course of the PCL, interposition of the PCL into the medial compartment of the knee joint may have been scanned on coronal MRI.…”

Section: Discussionmentioning

confidence: 99%

Interposition of the Posterior Cruciate Ligament into the Medial Compartment of the Knee Joint on Coronal Magnetic Resonance Imaging

et al. 2016

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ObjectiveThe purpose of our study was to evaluate the overall prevalence and clinical significance of interposition of the posterior cruciate ligament (PCL) into the medial compartment of the knee joint in coronal magnetic resonance imaging (MRI).Materials and MethodsWe retrospectively reviewed 317 consecutive patients referred for knee MRI at our institution between October 2009 and December 2009. Interposition of the PCL into the medial compartment of the knee joint on proton coronal MRI was evaluated dichotomously (i.e., present or absent). We analyzed the interposition according to its prevalence as well as its relationship with right-left sidedness, gender, age, and disease categories (osteoarthritis, anterior cruciate ligament tear, and medial meniscus tear).ResultsPrevalence of interposition of PCL into the medial compartment of the knee joint was 47.0% (149/317). There was no right (50.0%, 83/166) to left (43.7%, 66/151) or male (50.3%, 87/173) to female (43.1%, 62/144) differences in the prevalence. There was no significant association between the prevalence and age, or the disease categories.ConclusionInterposition of the PCL into the medial compartment of the knee joint is observed in almost half of patients on proton coronal MRI of the knee. Its presence is not associated with any particular factors including knee pathology and may be regarded as a normal MR finding.

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Radiographic study on the tibial insertion of the posterior cruciate ligament

Cited by 4 publications

References 18 publications

Isolated Posterior Cruciate Reconstruction Results in Improved Functional Outcome but Low Rates of Return to Preinjury Level of Sport: A Systematic Review and Meta-analysis

Isolated Posterior Cruciate Reconstruction Results in Improved Functional Outcome but Low Rates of Return to Preinjury Level of Sport: A Systematic Review and Meta-analysis

Application of CT‐MRI Fusion‐Based Three‐Dimensional Reconstruction Technique in the Anatomic Study of Posterior Cruciate Ligament

Interposition of the Posterior Cruciate Ligament into the Medial Compartment of the Knee Joint on Coronal Magnetic Resonance Imaging

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