Kinematics of the Posterior Cruciate Ligament/Posterolateral Corner-injured Knee After Reconstruction by Single- and Double-bundle Intra-articular Grafts.
From: Walter A. Hoyt, Jr, Musculoskeletal Research Laboratory, Department of Orthopaedic Surgery, Summa Health System, PO Box 2090, 444 North Main Street, Akron, OH 44309-2090, USA.
The American journal of sports medicine
- Publish Date: May 2006
- ISSN: 0363-5465
- Volume: 34
- Issue: 5
- Pages: 741-8
- Medium: Print
- Language: English
- Citation (JAMA): Wiley William B, Askew Michael J, Melby Arne, et al. Kinematics of the Posterior Cruciate Ligament/Posterolateral Corner-injured Knee After Reconstruction by Single- and Double-bundle Intra-articular Grafts.. May 2006;34:741-8
Abstract
BACKGROUND: Single- and double-bundle reconstructions have been proposed for the knee after combined posterior cruciate ligament/posterolateral corner injuries. HYPOTHESIS: The double-bundle posterior cruciate ligament reconstruction is superior to the single-bundle posterior cruciate ligament reconstruction with regard to restoration of normal knee kinematics to the posterior cruciate ligament/posterolateral corner-sectioned knee. STUDY DESIGN: Controlled laboratory study. METHODS: Kinematics of 8 fresh-frozen, cadaveric human knees were determined in the following conditions: intact, sectioned posterior cruciate ligament/posterolateral corner, single anterolateral bundle posterior cruciate reconstruction, and double-bundle posterior cruciate reconstruction. RESULTS: The sectioned knee demonstrated a posterior shift of the tibial neutral position and the abnormal posterior, varus, and external rotation laxities used clinically to define a combined posterior cruciate ligament/posterolateral corner injury. Both reconstructions restored the posterior laxity to levels that were not statistically different from those seen in the intact knee, but the double-bundle reconstruction more closely mimicked the posterior laxity profile of the intact knee, having statistically lower posterior laxities than did the single-bundle reconstruction at 30 degrees, 60 degrees, and 90 degrees of flexion (P < .05, analysis of variance, HSD test). The resting position of the tibia after double-bundle reconstruction trended to be anteriorly subluxated relative to its position for the intact knee at flexion angles of 30 degrees and greater (P <.05, paired t test). Neither technique corrected the abnormal varus or external rotation laxities. CONCLUSION: With either single- or double-bundle reconstructions, additional posterolateral reconstruction is recommended to correct the external rotation laxity. CLINICAL RELEVANCE: Knowledge of the kinematics of the combined posterior cruciate ligament/posterolateral corner-injured knee is important in the proper diagnosis of the injury and in the selection of the appropriate surgical reconstruction.
Mesh Headings (Keywords): Aged, Aged, 80 and over, Biomechanics, Cadaver, Humans, Knee Injuries, Posterior Cruciate Ligament, Reconstructive Surgical Procedures, Transplants
Check for Full Text / PubMed Unique Identifier (PMID): 16382008
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