| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Sign In to gain access to subscriptions and/or personal tools.
|
|
|
|||||||
Sign In to gain access to subscriptions and/or personal tools. |
|||||||||
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
Presented at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, July 1998.
Address correspondence and reprint requests to Christopher D. Harner, MD, Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, POB 71199, Pittsburgh, PA 15213
We hypothesized that posterior cruciate ligament reconstructions are often compromised by associated injuries to the posterolateral structures. Therefore, we evaluated a posterior cruciate ligament reconstruction in isolated and combined injury models using a robotic/universal force-moment sensor testing system. The resulting knee kinematics and the in situ forces in the native and reconstructed posterior cruciate ligament were determined under four external loading conditions. In the isolated injury model, reconstruction reduced posterior tibial translation to within 1.5 ± 1.3 to 2.4 ± 1.4 mm of the intact knee at 30° and 90° under a 134-N posterior tibial load. In the combined injury model, deficiency of the posterolateral structures increased posterior tibial translation of the reconstructed knee by 6.0 ± 2.7 mm at 30° and 4.6 ± 1.5 mm at 90° of flexion. External rotation increased up to 14° while varus rotation increased up to 7°. In situ forces in the posterior cruciate ligament graft also increased significantly (by 22% to 150%) for all loading conditions. Our results demonstrate that a graft that restores knee kinematics for an isolated posterior cruciate ligament deficiency is rendered ineffective and may be overloaded if the posterolateral structures are deficient. Therefore, surgical reconstruction of both structures is recommended in the setting of a combined injury.
This article has been cited by other articles:
|
|
 |
|
  A. Ranawat, C. L. Baker III, S. Henry, and C. D. Harner Posterolateral Corner Injury of the Knee: Evaluation and Management J. Am. Acad. Ortho. Surg., September 1, 2008; 16(9): 506 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Sekiya, D. R. Whiddon, C. T. Zehms, and M. D. Miller A Clinically Relevant Assessment of Posterior Cruciate Ligament and Posterolateral Corner Injuries. Evaluation of Isolated and Combined Deficiency J. Bone Joint Surg. Am., August 1, 2008; 90(8): 1621 - 1627. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Petersen, S. Loerch, S. Schanz, M. Raschke, and T. Zantop The Role of the Posterior Oblique Ligament in Controlling Posterior Tibial Translation in the Posterior Cruciate Ligament-Deficient Knee Am. J. Sports Med., March 1, 2008; 36(3): 495 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Apsingi, T. Nguyen, A. M. J. Bull, A. Unwin, D. J. Deehan, and A. A. Amis Control of Laxity in Knees With Combined Posterior Cruciate Ligament and Posterolateral Corner Deficiency: Comparison of Single-Bundle Versus Double-Bundle Posterior Cruciate Ligament Reconstruction Combined With Modified Larson Posterolateral Corner Reconstruction Am. J. Sports Med., March 1, 2008; 36(3): 487 - 494. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. N. Vinson, N. M. Major, and C. A. Helms The Posterolateral Corner of the Knee Am. J. Roentgenol., February 1, 2008; 190(2): 449 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Fornalski, M. H. McGarry, R. P. Csintalan, D. C. Fithian, and T. Q. Lee Biomechanical and Anatomical Assessment After Knee Hyperextension Injury Am. J. Sports Med., January 1, 2008; 36(1): 80 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Garavaglia, A. Lubbeke, V. Dubois-Ferriere, D. Suva, D. Fritschy, and J. Menetrey Accuracy of Stress Radiography Techniques in Grading Isolated and Combined Posterior Knee Injuries: A Cadaveric Study Am. J. Sports Med., December 1, 2007; 35(12): 2051 - 2056. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Arthur, R. F. LaPrade, and J. Agel Proximal Tibial Opening Wedge Osteotomy as the Initial Treatment for Chronic Posterolateral Corner Deficiency in the Varus Knee: A Prospective Clinical Study Am. J. Sports Med., November 1, 2007; 35(11): 1844 - 1850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Chang, S. C. Seong, S. Lee, J. H. Yoo, Y. K. Park, and M. C. Lee Novel Methods for Diagnosis and Treatment of Posterolateral Rotatory Instability of the Knee J. Bone Joint Surg. Am., October 1, 2007; 89(suppl_3): 2 - 14. [Full Text] [PDF]
|
|
|
|
|
|
B. R. Coobs, R. F. LaPrade, C. J. Griffith, and B. J. Nelson Biomechanical Analysis of an Isolated Fibular (Lateral) Collateral Ligament Reconstruction Using an Autogenous Semitendinosus Graft Am. J. Sports Med., September 1, 2007; 35(9): 1521 - 1527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J Strauss, C. Ishak, C. Inzerillo, M. Walsh, G. Yildirim, P. Walker, L. Jazrawi, J. Rosen, and R. F LaPrade Effect of tibial positioning on the diagnosis of posterolateral rotatory instability in the posterior cruciate ligament-deficient knee * COMMENTARY Br. J. Sports Med., August 1, 2007; 41(8): 481 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Markolf, B. R. Graves, S. M. Sigward, S. R. Jackson, and D. R. McAllister How Well Do Anatomical Reconstructions of the Posterolateral Corner Restore Varus Stability to the Posterior Cruciate Ligament-Reconstructed Knee? Am. J. Sports Med., July 1, 2007; 35(7): 1117 - 1122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Csintalan, A. Ehsan, M. H. McGarry, D. F. Fithian, and T. Q. Lee Biomechanical and Anatomical Effects of an External Rotational Torque Applied to the Knee: A Cadaveric Study Am. J. Sports Med., October 1, 2006; 34(10): 1623 - 1629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Zhao, Y. He, and J. Wang Anatomical Reconstruction of Knee Posterolateral Complex With the Tendon of the Long Head of Biceps Femoris Am. J. Sports Med., October 1, 2006; 34(10): 1615 - 1622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. R. Noyes, S. D. Barber-Westin, and J. C. Albright An Analysis of the Causes of Failure in 57 Consecutive Posterolateral Operative Procedures Am. J. Sports Med., September 1, 2006; 34(9): 1419 - 1430. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. LaPrade, F. A. Wentorf, E. J. Olson, and C. S. Carlson An In Vivo Injury Model of Posterolateral Knee Instability Am. J. Sports Med., August 1, 2006; 34(8): 1313 - 1321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Davis, D. H. Goltz, D. C. Fithian, and D. D'Lima Anatomical Posterior Cruciate Ligament Transplantation: A Biomechanical Analysis Am. J. Sports Med., July 1, 2006; 34(7): 1126 - 1133. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. B. Wiley, M. J. Askew, A. Melby III, and D. A. Noe Kinematics of the Posterior Cruciate Ligament/Posterolateral Corner-Injured Knee After Reconstruction by Single- and Double-Bundle Intra-articular Grafts Am. J. Sports Med., May 1, 2006; 34(5): 741 - 748. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Petersen, S. Lenschow, A. Weimann, M. J. Strobel, M. J. Raschke, and T. Zantop Importance of Femoral Tunnel Placement in Double-Bundle Posterior Cruciate Ligament Reconstruction: Biomechanical Analysis Using a Robotic/Universal Force-Moment Sensor Testing System Am. J. Sports Med., March 1, 2006; 34(3): 456 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nau, Y. Chevalier, N. Hagemeister, J. A. deGuise, and N. Duval Comparison of 2 Surgical Techniques of Posterolateral Corner Reconstruction of the Knee Am. J. Sports Med., December 1, 2005; 33(12): 1838 - 1845. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-M. Brinkman, P. J. A. Schwering, L. Blankevoort, J. G. Koolos, J. Luites, and A. B. Wymenga The insertion geometry of the posterolateral corner of the knee J Bone Joint Surg Br, October 1, 2005; 87-B(10): 1364 - 1368. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. LaPrade, T. S. Bollom, F. A. Wentorf, N. J. Wills, and K. Meister Mechanical Properties of the Posterolateral Structures of the Knee Am. J. Sports Med., September 1, 2005; 33(9): 1386 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-B. Jung, H.-J. Jung, S.-K. Tae, Y.-S. Lee, and K.-H. Lee Reconstruction of the Posterior Cruciate Ligament with a Mid-Third Patellar Tendon Graft with Use of a Modified Tibial Inlay Method J. Bone Joint Surg. Am., September 1, 2005; 87(1_suppl_2): 247 - 263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Sekiya, M. J. Haemmerle, K. J. Stabile, T. M. Vogrin, and C. D. Harner Biomechanical Analysis of a Combined Double-Bundle Posterior Cruciate Ligament and Posterolateral Corner Reconstruction Am. J. Sports Med., March 1, 2005; 33(3): 360 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. LaPrade, S. Johansen, F. A. Wentorf, L. Engebretsen, J. L. Esterberg, and A. Tso An Analysis of an Anatomical Posterolateral Knee Reconstruction: An In Vitro Biomechanical Study and Development of a Surgical Technique Am. J. Sports Med., September 1, 2004; 32(6): 1405 - 1414. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Li, L. E. DeFrate, H. Sun, and T. J. Gill In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament During Knee Flexion Am. J. Sports Med., September 1, 2004; 32(6): 1415 - 1420. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Park, B. D. Stamos, L. E. DeFrate, T. J. Gill, and G. Li The Effect of Posterior Knee Capsulotomy on Posterior Tibial Translation During Posterior Cruciate Ligament Tibial Inlay Reconstruction Am. J. Sports Med., September 1, 2004; 32(6): 1514 - 1519. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Oakes, K. L. Markolf, J. McWilliams, C. R. Young, and D. R. McAllister The Effect of Femoral Tunnel Position on Graft Forces During Inlay Posterior Cruciate Ligament Reconstruction Am. J. Sports Med., September 1, 2003; 31(5): 667 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Ahmad, Z. A. Cohen, W. N. Levine, T. R. Gardner, G. A. Ateshian, and V. C. Mow Codominance of the Individual Posterior Cruciate Ligament Bundles: An Analysis of Bundle Lengths and Orientation Am. J. Sports Med., March 1, 2003; 31(2): 221 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Oakes, K. L. Markolf, J. McWilliams, C. R. Young, and D. R. McAllister Biomechanical Comparison of Tibial Inlay and Tibial Tunnel Techniques for Reconstruction of the Posterior Cruciate Ligament : Analysis of Graft Forces J. Bone Joint Surg. Am., June 1, 2002; 84(6): 938 - 944. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Covey Injuries of the Posterolateral Corner of the Knee J. Bone Joint Surg. Am., January 1, 2001; 83(1): 106 - 106. [Full Text]
|
|
| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
