The Effect of Posterior Cruciate Ligament Reconstruction on Patellofemoral Contact Pressures in the Knee Joint under Simulated Muscle Loads

Gill, Thomas J.; DeFrate, Louis E.; Wang, Conrad; Carey, Christopher T.; Zayontz, Shay; Zarins, Bertram; Li, Guoan

doi:10.1177/0095399703258794

Cited by 88 publications

(54 citation statements)

References 42 publications

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“…To evaluate the effectiveness of surgical treatment, few experimental studies have been conducted to measure the tibiofemoral and patellofemoral forces after PCL surgery (Kanamori et al, 2000;Skyhar et al, 1993). Gill et al (2004) measured the contact pressures induced by ''native'', deficient and reconstructed PCL in the patellofemoral joint for different angles of knee flexion, by using a thin film transducer. They observed that contact pressures were higher for a PCL-deficient knee and for a reconstructed knee, which might contribute to the long-term degeneration observed in both nonoperatively treated and PCL-reconstructed knees.…”

Section: Introductionmentioning

confidence: 99%

Effects of the posterior cruciate ligament reconstruction on the biomechanics of the knee joint: a finite element analysis

Ramaniraka

Terrier

Theumann

et al. 2005

Clinical Biomechanics

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Background. Previous experimental studies have been conducted to evaluate the biomechanical effects of posterior cruciate ligament reconstruction; but no consensus has been reached on the preferred method of reconstruction.Methods. The 3D finite element mesh of a knee joint was reconstructed from computed tomography and magnetic resonance images. The ligaments were considered as hyperelastic materials. The tibiofemoral and patellofemoral joints were modeled with large sliding contact elements. The 3D model was used to simulate knee flexion from 0°to 90°in four cases: a knee with a ''native'' posterior cruciate ligament, a resected posterior cruciate ligament, a reconstructed single graft posterior cruciate ligament, and a reconstructed double graft posterior cruciate ligament.Findings. A resected posterior cruciate ligament induced high compressive forces in the medial tibiofemoral and patellofemoral compartments. The pressures generated in the tibiofemoral and patellofemoral compartments were nearly the same for the two reconstruction techniques (single graft and double graft). The single graft resulted in lower tensile stresses inside the graft than for the double graft.Interpretation. Firstly, a resected posterior cruciate ligament should be replaced to avoid excessive compressive forces, which are a source of cartilage degeneration. Secondly, the two types of posterior cruciate ligament reconstruction techniques partially restored the biomechanics of the knee in flexion, e.g. contact pressures were restored for pure flexion of the knee. The reconstruction techniques therefore partially restore the biomechanics of the knee in flexion. A double graft reconstruction is subjected to the highest tensile stresses.

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Section: Introductionmentioning

confidence: 99%

Effects of the posterior cruciate ligament reconstruction on the biomechanics of the knee joint: a finite element analysis

Ramaniraka

Terrier

Theumann

et al. 2005

Clinical Biomechanics

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“…It has been demonstrated that nonoperatively treated grade II or III PCL-deficient knees show a high incidence of degenerative changes, particularly in the patellofemoral and medial compartments. 4,9,15,27 Therefore, reconstruction is gaining popularity, with a view toward protecting the knee from degenerative changes by reducing patellofemoral contact pressures and preventing future episodes of instability and possible meniscal or chondral injuries. 11,13 The most commonly used PCL reconstruction methods are the transtibial or the tibial inlay.…”

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confidence: 99%

Transtibial Versus Tibial Inlay Techniques for Posterior Cruciate Ligament Reconstruction

Song

Park²,

Ahn

et al. 2014

Am J Sports Med

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“…[4][5][6][7] However, proper placement of the tibial tunnel is also important because its location can directly affect the posterior and rotational instability of the knee joint. 8 Therefore, an accurate method for precise tibial tunnel preparation is necessary in transtibial PCL reconstruction.…”

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confidence: 99%

Tibial Tunnel Aperture Location During Single-Bundle Posterior Cruciate Ligament Reconstruction: Comparison of Tibial Guide Positions

Shin

Han

Hwang

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The Effect of Posterior Cruciate Ligament Reconstruction on Patellofemoral Contact Pressures in the Knee Joint under Simulated Muscle Loads

Abstract: The elevated contact pressures observed in the PCL-deficient knee and reconstructed knee might contribute to the long-term degeneration observed in both the non-operatively treated and PCL-reconstructed knees.

Cited by 88 publications

References 42 publications

Effects of the posterior cruciate ligament reconstruction on the biomechanics of the knee joint: a finite element analysis

Effects of the posterior cruciate ligament reconstruction on the biomechanics of the knee joint: a finite element analysis

Transtibial Versus Tibial Inlay Techniques for Posterior Cruciate Ligament Reconstruction

Tibial Tunnel Aperture Location During Single-Bundle Posterior Cruciate Ligament Reconstruction: Comparison of Tibial Guide Positions

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