Rupture of posterior cruciate ligament leads to radial displacement of the medial meniscus

Zhang, Can; Deng, Zhenhan; Luo, Wei; Xiao, Wenfeng; Hu, Yihe; Zhan, Lin; Li, Kanghua; He, Hongbo

doi:10.1186/s12891-017-1646-6

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…This could partially explain limitation of extreme flexion (73.2% of patients) and extension (19.5% of patients) before operation, and range of motion improved greatly after meniscal tear being treated with either partial meniscectomy or meniscal repair. Zhang et al [ 25 ] reported PCL injury resulted in radial displacement of the medial meniscus which may lead to degenerative changes of meniscus. A study by Gao et al [ 26 ] revealed human cadaveric knee with PCL transection had a higher strain on whole medial meniscus.…”

Section: Discussionmentioning

confidence: 99%

Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years

Liu

Chiu

Chang

et al. 2022

BMC Musculoskelet Disord

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Background To assess clinical and functional outcomes of patients aged 40 years or older receiving PCL reconstruction surgery. Methods All patients older than 40 years with isolated PCL rupture who underwent PCL reconstruction surgery were enrolled into the retrospective study. Associated meniscal injuries, osteochondral lesions, postoperative complications, and the rate of return to the preinjury level of activity were extracted. Outcomes included International Knee Documentation Committee (IKDC) subjective score, Lysholm score, and Tegner activity score. The minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) were used to evaluate the clinically relevant value of PCL reconstruction in this population. Results In total, 41 patients with a mean age of 51.7 years were included. The mean follow-up time was 32.8 months. Associated lesions included meniscal injuries (48.8%) and osteochondral lesions (97.6%). Improvement in the IKDC score (from 46.5 preoperatively to 79.0 postoperatively, p < 0.0001), Lysholm score (from 65.5 to 88.3, p < 0.0001), and Tegner activity score (from 2.3 to 4.0, p < 0.0001) was recorded. The clinically relevant value based on the MCID showed that 34 of 41 patients (82.9%) had a ΔIKDC score exceeding 16.8; all patients (100%) showed a ΔLysholm score exceeding 8.9; and 35 of 41 patients (85.4%) showed a ΔTegner activity score exceeding 0.5. Regarding the PASS, none of the patients had an IKDC score exceeding 75.9 preoperatively, whereas 27 of 41 patients (65.9%) had a score of more than 75.9 postoperatively. All patient had ≥ grade II knee instability preoperatively. Postoperatively, 36 patients (87.8%) had no significant joint translation, and 5 patients (12.2%) had grade I instability. Twenty-one patients (51.2%) returned to their preinjury level of activity. Five patients (12.2%) developed Ahlbäck grade I radiographic osteoarthritis. No rerupture or other major perioperative complications were reported. Conclusions PCL reconstruction is a reliable surgery for middle-aged patients suffering from persistent instability even after failed conservative treatment, with significant improvement in patient-reported outcomes that exceeded MCID in the majority of patients, restoration of subjective instability, and approximately half of the patients returned to preinjury activity levels. Level of evidence Level IV, therapeutic case series.

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Section: Discussionmentioning

confidence: 99%

Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years

Liu

Chiu

Chang

et al. 2022

BMC Musculoskelet Disord

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“…Lateral meniscus injury is more common in acute injuries, with or without cruciate ligament injury. [11][12][13] The injury of the medial meniscus, especially the injury of the posterior horn of the medial meniscus. It's common in older people, but it's also common in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Application of exposure enhancement technique combined with femoral condyle pushing technique in repairing the posterior horn of the medial meniscus under knee arthroscopy

Li¹,

Xiang²,

Zi³

et al. 2022

Pak J Med Sci

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Objectives: To investigate the clinical efficacy of exposure enhancement technique and femoral condyle pushing technique applying in the posterior horn of the medial meniscus of the knee. Methods: From January 2016 to June 2019, 52 patients with injury in the medial meniscus treated in our department were selected. The horizontal tear of the posterior horn of the medial meniscus was repaired by exposure enhancement technique and femoral condyle pushing technique using the meniscus suture system. Postoperatively, the efficacy was evaluated using the Lysholm scoring system. Results: These 52 patients were all followed up for 3~18 months, with an average of 12.5 ± 7.3 months. The pain and activity of all patients were significantly improved compared with those before surgery. Conclusion: Exposure enhancement technique and femoral condyle pushing technique in the repair of the posterior horn of the medial meniscus presents satisfactory efficacy. It can improve the pain and activity of the knee, and enhance the stability of residual meniscus. Therefore, it is worth promoting. doi: https://doi.org/10.12669/pjms.38.6.5176 How to cite this:Liu X, Xiang D, Zi Y, Han T, Xue C. Application of exposure enhancement technique combined with femoral condyle pushing technique in repairing the posterior horn of the medial meniscus under knee arthroscopy. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5176 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…The menisci play an important role in protecting the cartilage surfaces of the knee joint from axial loads [ 9 ]. Recently, the treatment of the PRMM is not uniform including conservative treatment, meniscectomy, and meniscus repair [ 10 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

A technique combining “U” shape suture and shared tunneling to treat the posterior cruciate ligament rupture and posterior root tears of the medial meniscus

Xue

Lin

et al. 2018

J Orthop Surg Res

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BackgroundThe standard treatment of the posterior cruciate ligament (PCL) rupture accompanied with the posterior root of medial meniscus (PRMM) tears is controversial. Our research describes a minimally invasive technique for the PCL rupture accompanied with the PRMM tears.MethodsWe described a “U” shape suture and shared tunneling technique to treat the PCL rupture accompanied with PRMM tears. Three patients (ages 28, 42, and 59 years old) who underwent this surgery have been followed up for more than 1 year at most. The MRI was done, and the hospital for special surgery (HSS) score was adopted to evaluate the clinical effect. Firstly, we built both femoral and tibial bone tunnels for the PCL reconstruction. Secondly, we used the suture hook to pass the suture line through the PRMM. Thirdly, we passed the prepared tendon through the bone tunnel and fixed the prepared tendon by an endobutton plate and an interference screw (Smith & Nephew) respectively on the side of the femur and tibia. At last, we used an endobutton plate (Smith & Nephew) outside the tibial bone tunnel to fix the PRMM.ResultsThese three patients did not show any complications. At 1 year after the operation, we found good knee stability, negative posterior drawer test, and normal range of motion compared with the contralateral knee joint. The MRI also showed a good union of the PRMM and PCL. The hospital for special surgery (HSS) score was 90 points.ConclusionsWith an ideal therapeutic effect, this technique is worthy to be promoted for patients with the PCL rupture and PRMM tears.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0973-0) contains supplementary material, which is available to authorized users.

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Rupture of posterior cruciate ligament leads to radial displacement of the medial meniscus

Cited by 7 publications

References 27 publications

Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years

Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients over the age of 40 years

Application of exposure enhancement technique combined with femoral condyle pushing technique in repairing the posterior horn of the medial meniscus under knee arthroscopy

A technique combining “U” shape suture and shared tunneling to treat the posterior cruciate ligament rupture and posterior root tears of the medial meniscus

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