• Title/Summary/Keyword: PCL(posterior cruciate ligament)

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Complications of PCL Reconstruction using Tibial Inlay Technique (경골 Inlay 방법을 이용한 후방 십자 인대 재건술의 합병증)

  • Kim Myung-Ho;Park Hee-Gon;Yoo Moon-Jib;Byun Woo-Sup;Shim Shang-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.128-133
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    • 2004
  • Purpose: This study was planned to evaluate complications? of posterior cruciate ligament (PCL) reconstruction with tibial inlay technique using autogenous bone-patellar tendon-bone graft. Materials and Methods: From September 1994 to January 2004, we analyzed surgical complications in fifty-seven patients with fifty-eight cases who underwent PCL reconstruction. Fifty of them were male and seven female. The mean age of the patients was 35(15$\~$73). Twenty eight cases of injury were isolated PCL, while thirty cases had associated injury of knee. The causes of injury were thirty-nine cases of traffic accident, seven sport injuries, seven fall down injuries, and five of others. The follow-up study was done at 4 weeks, 3 months,6 months and 1 year after surgery. KT-2000 arthrometer and posterior stress X-ray were used to examine the stability of the knee joint and the Lysholm Knee Score and a variety of clinical complications were evaluated. Results: Although the mean score of the preoperative Lysholm Knee Score was 43.2, the postoperative score was increased to 87.9. The preoperative mean value of knee stability using KT-2000 arthrometer was 8.75 mm(6.2$\~$14.3 mm) but the postoperative mean was 3.41 mm(2.1$\~$10.6 mm). The intraoperative complications were: one case of popliteal artery injury with compartment syndrome, one case of patellar fracture, two cases of 20$^{\circ}$ flexion loss, and two cases of anterior cortical penetration of the screw through proximal tibia during screw fixation. The postoperative complications were: eleven cases of knee instability, one case of patellar fracture, five cases of extension loss, thirteen cases of flexion loss, twenty-one cases of around knee pain and eight cases of kneeling pain. Conclusion: After PCL reconstruction with tibial inlay technique using autogenous bone-patella tendon-bone graft, complications were observed in this study. Careful attention during and after the operation, as well as rehabilitation must be required.

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Reconstruction of Posterior Cruciate Ligament and Posterolateral Structure with Allo-Achilles Tendon (동종 아킬레스 건을 이용한 후방 십자 인대 및 후 외방 구조물 재건술)

  • Oh, In-Suk;Lee, Dong-Joo;Cho, Kyu-Jung;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.162-166
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    • 2005
  • Purpose: The purpose of this study were to evaluate the results of arthroscopic PCL reconstruction and posterolateral structure reconstruction. Materials and Methods: We performed 10 cases of arthrocopic PCL and posterolateral structure reconstruction using allo-achilles tendon. The average follow-up period was 25 months. We performed KT-2000 testing and posterior drawer test for posterior instability and tibial external rotation test for posterolateral rotatory instability, and measure Tegner and Lysholm score preoperatively and compared these with the results of a final evaluation in each cases. Results: The Preoperative average KT-2000 tests was 7.1 mm, posterior drawer test was Grade III and tibial external rotation test was positive at both 30 and 90 degrees of knee flexion in all cases. Preoperative average Lysholm score was 65.9 and Tegner score was 3.1. At the final evaluation, an average KT-2000 test was 2.2 mm, posteior drawer test, Grade 0 was 2 cases, Grade 1.4 cases, Grade II, 3 cases, Grade III, 1 cases. The tibial external rotation test at both 30 and 90 degrees of knee flexion was positive in 1 cases and positive at only 90 degrees in 2 cases. Lysholm score was 87.6 and Tegner score was 5.7. The objective and subjective score of final evaluation is increased in compare with preoperative one. Conclusion: Arthrocopic PCL and posterolateral structure reconstruction using allo-achilles tendon is one of the good surgical treatment method in patients having posterior and posterolateral rotatory instability.

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ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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Arthroscopic Reconstruction of Posterior Cruciate Ligament with Achilles Tendon Allograft (동종 이식 아킬레스 건을 이용한 관절경적 후방 십자 인대 재건술)

  • Kim, Kyung Taek;Sohn, Sung Keun;Lee, Dae Hee
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.9-16
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    • 1999
  • Purpose : We have evaluated the outcome of the operative treatment of PCL rupture using the achilles tendon allograft. Materials and Methods : A retrospective study was completed for 30-PCL reconstruction cases, using the achilles tendon allograft from september 1996 to march 1998. There was an average follow up of 24 months, with range of 12 to 50 months. Results : The active range of motion was improved postoperatively. The Lysholm Knee Score was improved from a mean of 54 points preoperatively to 87 points postoerative 18 months. The "Cybex 340 isometric test" revealed satisfactory results compared with autograft. Conclusions : Use of allograft for recostruction of the PCL is an attractive option because it precludes the harvesting of autogenous tissue in a knee that is already at risk for patellofemoral and tibiofemoral osteoarthrosis.

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