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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The posterior cruciate ligament originates from the anterolateral aspect of the medial femoral condyle within the intercondylar notch10 and inserts along the posterior aspect of the tibial plateau, approximately 1 cm distal to articular surface of the tibia (Logterman et al. 2018).11 It crosses the anterior cruciate ligament to form an “x.” The posterior cruciate ligament consists of two inseparable bundles: the anterolateral bundle for mid-flexion and internal rotation of the knee and the posteromedial bundle for extension and deep flexion of the knee.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The cruciate ligaments are two very strong ligaments that cross each other within the joint cavity, but are excluded from the synovial cavity by a covering of synovial membrane (they are therefore described as being intracapsular, but extrasynovial). They are crucial in the sense that they are essential for stability of the knee. They are named anterior and posterior according to their tibial attachments. Thus the anterior cruciate ligament is attached to the anterior intercondylar area of the tibia and runs upwards, backwards and laterally to attach itself to the medial surface of the lateral femoral condyle. The anterior cruciate prevents anterior displacement of the tibia on the femur. Backward displacement of the tibia on the femur is prevented by the stronger posterior cruciate ligament. The integrity of the latter is therefore important when walking down stairs or downhill. Tears of the anterior cruciate ligament are common in sports injuries, whereas tears of the posterior cruciate ligament are rare since it is much stronger than the anterior cruciate.
The knee
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Andrew Price, Nick Bottomley, William Jackson
The cruciate ligaments are essential for stability of the knee. The anterior cruciate ligament prevents forward displacement of the tibia on the femur and, in particular, it prevents forward subluxation of the lateral tibial condyle (i.e. rotation), a movement that tends to occur if a person who is running twists suddenly. The posterior cruciate ligament prevents backward displacement of the tibia on the femur and its integrity is therefore important when progressing downhill.
Biomechanical study of medial meniscus after posterior horn injury: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Peishi Jiang, Juncheng Cui, Zhiwei Chen, Zhu Dai, Yangchun Zhang, Guoliang Yi
The corresponding contacts were set according to the physiological state of each part of the normal knee joint. (1) The frictional coefficient between meniscus body and cartilago articularis is small, wherein the frictional force can be ignored (Shriram et al. 2017). The upper surface of the medial and lateral meniscus was set as no-separation contact with femoral cartilage. The lower surface of the medial and lateral meniscus was set as no-separation contact with tibial plateau cartilage. The roots of meniscus were attached to tibial cartilage, and the anterior and posterior horn of meniscus was set as binding contact with tibial cartilage (Cruz et al. 2017). (2) Binding contact was set between bone and anterior and posterior cruciate ligament as well as medial and lateral collateral ligament, femoral cartilage and femur, tibial cartilage and tibia, tibia and fibula according to the anatomical structures, suggesting impossible relative motion.
Superior fixation and less periprosthetic stress-shielding of tibial components with a finned stem versus an I-beam block stem: a randomized RSA and DXA study with minimum 5 years’ follow-up
Published in Acta Orthopaedica, 2019
Maiken Stilling, Inger Mechlenburg, Claus Fink Jepsen, Lone Rømer, Ole Rahbek, Kjeld Søballe, Frank Madsen
All patients were operated in a theatre with laminar airflow by 4 experienced knee surgeons. A tourniquet was applied and an anterior midline incision was used. The posterior cruciate ligament was retained in all cases. In both groups the proximal tibia was cut using the same extra-medullary guide, aiming for a perpendicular cut in the frontal plane and a posterior slope of 3°. The cut surfaces of the patella and femur were cleaned by high-pressure lavage before cementation. 5–6 tantalum beads (1 mm) (Wennbergs Finmek AB, Gunnilse, Sweden) were inserted in the proximal tibia intraoperatively. All patients received a draining tube in the joint for approximately 24 hours. All patients were treated prophylactically with a preoperative single dose i.v. 2 g dicloxacillin and all received prophylactic thrombotic medication with 1 daily dose subcutaneous 2.5 mg fondaparinux for 5 to 7 days. The patients were mobilized on the first postoperative day and allowed weight-bearing as tolerated, but with the assistance of 2 crutches for the first 6 weeks. The in-hospital stay varied between 4 and 6 days.
Sensitivity analysis of the knee ligament forces to the surgical design variation during anterior cruciate ligament reconstruction: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Malek Adouni, Tanvir R. Faisal, Yasin Y. Dhaher
Furthermore, several arthroscopic observations of failed ACL-R grafts showed that the grafts were strained due to impingement against the lateral bundle of the posterior cruciate ligament (PCL) (Strobel et al. 2001; Simmons et al. 2003; Fujimoto et al. 2004; Nishimori et al. 2007; Iriuchishima et al. 2010; Noyes 2012; Nakamura et al. 2017). These observations suggested that surgical parameters like femoral tunnel placement and graft pretension were responsible for this altered mechanical contact (impingement) between the graft and the PCL, resulting in high graft cyclic tension (Simmons et al. 2003; Fujimoto et al. 2004). However, the relative contributions of the surgical variables to the cruciate ligaments interaction following an ACL-R remain unclear.