Document Detail

Patella-tibial transfixation for posterior cruciate ligament repair and reconstruction: a biomechanical analysis.
MedLine Citation:
PMID:  9430575     Owner:  NLM     Status:  MEDLINE    
The posterior cruciate ligament (PCL) restricts posterior translation of the tibia on the femur. Because flexion of the knee increases tension on the PCL, the knee is usually immobilized in extension after PCL repair or reconstruction. Patella-tibial transfixation (olecranization), however, has been proposed to reduce the tension on the PCL without requiring immobilization of the knee. The objective of this study was: (1) to evaluate the distribution of strain in the anterolateral and posterior oblique fiber bundles of the PCLs in eight cadaveric knees before and after olecranization and (2) to measure the patellofemoral contact pressures at various degrees of knee flexion. Olecranization significantly (P < 0.05) reduced the strain on the anterolateral fiber bundles of the PCL at 15 degrees -45 degrees of flexion. No significant strain reduction was observed in the posterior oblique fiber bundles. Patellofemoral contact pressures measured from digitized Fuji sensitive film indicated significantly increased contact pressures (P < 0.05) following olecranization from 0 degrees -60 degrees of knee flexion. Increased parapatellar soft tissue tightness limited knee flexion to 90 degrees and patella lift-off occurred at 75 degrees. Although olecranization of the patella does reduce strain on the intact PCL within a selected range of motion, the beneficial effect of allowing early motion may be negated by the potentially harmful effects imposed upon the patellofemoral articular cartilage by increased contact pressures.
H E Kambic; A G Dass; J T Andrish
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  5     ISSN:  0942-2056     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  1997  
Date Detail:
Created Date:  1998-01-29     Completed Date:  1998-01-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  245-50     Citation Subset:  IM    
Department of Biomedical Engineering, The Cleveland Clinic Foundation, OH 44195, USA.
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MeSH Terms
Knee Injuries / physiopathology,  surgery*
Middle Aged
Posterior Cruciate Ligament / injuries*,  physiopathology,  surgery*

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