scholarly journals Combined Posterior Cruciate Ligament and Superficial Medial Collateral Ligament Knee Reconstruction: Avoiding Tunnel Convergence

2019 ◽  
Vol 8 (8) ◽  
pp. e929-e933 ◽  
Author(s):  
Matthew D. Crawford ◽  
Mitchell I. Kennedy ◽  
David L. Bernholt ◽  
Nicholas N. DePhillipo ◽  
Robert F. LaPrade
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Collateral Ligament ◽  
Knee Reconstruction ◽  
Tunnel Convergence ◽  
Superficial Medial Collateral Ligament

Isolated Sectioning of the Medial and Posteromedial Capsular Ligaments in the Posterior Cruciate Ligament-Deficient Knee

1998 ◽  
Vol 26 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Joseph R. Ritchie ◽  
John A. Bergfeld ◽  
Helen Kambic ◽  
Timothy Manning
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Tibial Rotation ◽  
Collateral Ligament ◽  
Superficial Medial Collateral Ligament ◽  
Posterior Translation ◽  
Internal Tibial Rotation ◽  
Tibial Translation ◽  
Deficient Knee

This study was undertaken to determine the contribution of various structures in the posterior cruciate ligament-deficient knee in resisting posterior tibial translation. With “isolated” injuries to the posterior cruciate ligament, the amount of posterior translation will decrease with the posterior drawer test as the knee is taken from neutral to internal tibial rotation. The present study was performed to conclusively determine the anatomic structure responsible for this clinical observation. The TestStar device was used to perform single-plane posterior drawer tests in 14 cadaveric knee specimens. The tests were performed with the knee in neutral tibial rotation and in 20° of internal tibial rotation. The intact knee was tested and then the knee was tested after sequential sectioning of the meniscofemoral ligaments, the posterior cruciate ligament, the posteromedial capsule, and the superficial medial collateral ligament. With the knee in neutral rotation, posterior translation continued to increase as each structure was sectioned. With the knee in internal tibial rotation, posterior displacement was significantly less than in neutral rotation for each state until the superficial medial collateral ligament was sectioned; posterior translation was increased after its sectioning. Our data demonstrate that the superficial medial collateral ligament is the structure responsible for a decrease in posterior tibial translation in the posterior cruciate ligament-deficient knee.

scholarly journals Single-Stage Arthroscopic Anterior and Posterior Cruciate Ligament Repairs and Open Medial Collateral Ligament Repair for Acute Knee Dislocation

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ryo Murakami ◽  
Eisaburo Honda ◽  
Atsushi Fukai ◽  
Hiroki Yoshitomi ◽  
Takaki Sanada ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Knee Dislocation ◽  
Single Stage ◽  
Lateral Condyle ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Medial Condyle

Till date, there are no clear guidelines regarding the treatment of multiple ligament knee injuries. Ligament repair is advantageous as it preserves proprioception and does not involve grafting. Many studies have reported the use of open repair and reconstruction for multiple ligament knee injuries; however, reports on arthroscopic-combined single-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repairs are scarce. In this report, we describe a case of type III knee dislocation (ACL, PCL, and medial collateral ligament (MCL) injuries) in a 43-year-old man, caused by contact while playing futsal. On the sixth day after injury, arthroscopic ACL and PCL repairs were performed with open MCL repair. The proximal lesions in the three ligaments that were injured were sutured using no. 2 strong surgical sutures. The ACL was pulled out to the lateral condyle of the femur and fixed using a suspensory fixation device. The PCL was pulled out to the medial condyle of the femur, and the MCL was pulled towards the proximal end of the femur; both were fixed using suture anchors. Early mobilization was performed, and both, clinical and imaging outcomes, were good two years after surgery.

scholarly journals Avulsion of the Femoral Attachment of the Medial Collateral Ligament of the Knee Associated to Complete Tear of the Posterior Cruciate Ligament: A Case Report

2017 ◽  
Vol 03 (01) ◽  
pp. e38-e41 ◽  
Author(s):  
Sleiman Haddad ◽  
Andrea Sallent ◽  
Joan Minguell ◽  
Enric Castellet
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Return To Play ◽  
Surgical Reconstruction ◽  
Collateral Ligament ◽  
Complete Tear ◽  
Flexion Extension ◽  
Femoral Avulsion

AbstractMedial collateral ligament (MCL) of the knee is one of the most commonly injured ligaments of the knee. Incidence of posterior cruciate ligament (PCL) injuries can vary widely. Conservative treatment has shown good clinical outcomes and relatively rapid return to play in both injuries alone. We present the case of a 38-year-old male who presented a combined MCL avulsion injury and PCL tear treated surgically. The PCL was reconstructed using the double-bundle Achilles allograft technique. Within the same surgery, a medial femoral incision was performed to reinsert the avulsion of the bone fragment rotated and distally retracted together with the MCL with bone anchors and Spike Washer. Two years after surgery, the patient enjoyed a 0/140-degree range of motion for flexion/extension. He had returned to sports and was pain-free. In conclusion, femoral avulsion of the MCL associated to PCL injury is a rare and nondescribed injury that, as opposed to most MCL isolated injuries, might benefit from early surgical reconstruction.

Combined reconstruction of the posterior cruciate ligament and medial collateral ligament using a single femoral tunnel

2016 ◽  
Vol 25 (10) ◽  
pp. 3024-3030 ◽  
Author(s):  
Marcelo Batista Bonadio ◽  
Camilo Partezani Helito ◽  
Noel Oizerovici Foni ◽  
Roberto Freire da Mota e Albuquerque ◽  
José Ricardo Pécora ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Collateral Ligament

Does Nitric Oxide Help Explain the Differential Healing Capacity of the Anterior Cruciate, Posterior Cruciate, and Medial Collateral Ligaments?

2000 ◽  
Vol 28 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Cao Min ◽  
Maja Stefanovic-Racic ◽  
Helga I. Georgescu ◽  
Freddie H. Fu ◽  
Christopher H. Evans
Keyword(s):  
Nitric Oxide ◽  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Collagen Synthesis ◽  
Cruciate Ligament ◽  
Cruciate Ligaments ◽  
Matrix Synthesis ◽  
Collateral Ligament ◽  
Anterior Cruciate

This study compared the ability of rabbit medial collateral ligament, posterior cruciate ligament, and anterior cruciate ligament tissue to synthesize nitric oxide, and determined its effects on matrix synthesis, an important component of ligament repair. It is not known whether ligament cells can produce nitric oxide and, if so, whether it influences healing of ligament injuries. The anterior cruciate and posterior cruciate ligament tissue produced large amounts of nitric oxide in response to the inflammatory cytokine interleukin-1. Medial collateral ligament, in contrast, produced only modest amounts of nitric oxide. Furthermore, anterior cruciate ligament and, to some degree, posterior cruciate ligament synthesized nitric oxide spontaneously in culture, whereas medial collateral ligament never did so. When nitric oxide was supplied to these tissues, it strongly inhibited collagen synthesis by the two cruciate ligaments, but had little effect on collagen synthesis by the medial collateral ligament. Endogenously synthesized nitric oxide was also able to inhibit collagen synthesis as well as proteoglycan synthesis by the two cruciate ligaments, but had little effect on matrix synthesis by the medial collateral ligament. We propose a novel hypothesis, based on nitric oxide production and matrix synthesis, that may help explain why the two cruciate ligaments have such limited healing capacity compared with the medial collateral ligament.

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