Posterior problems in the knee

Abstract

During a recent three-year period, 39 patients under went surgical procedures for lesions of the posterior complex of the knee. The results in 28 followed for greater than six months (average followup, 16 months) are reported; eight are presently in the early rehabili tative phase and three have been lost to followup.

In reconstruction for chronic laxity, a semitendino sus replacement of the posterior cruciate ligament with anterior advancement of the lateral arcuate com plex is recommended. Use of the medial gastroc nemius tendon is still advised in selected cases. Re construction for posterolateral rotatory laxity with an intact posterior cruciate is performed with anterior advancement of the popliteus tendon and the arcuate complex. Pes anserinus transfer, imbrication of the posterior oblique ligament, and biceps tenodesis may be performed as supplemental procedures.

Get full access to this article

View all access options for this article.

References

Girgis FG Cruciate ligaments of the knee Anatomical and functional analysis Clin Orthop 106 216-231, 1975

Hughston JC The posterior cruciate ligament J Bone Jomt Surg 51A 1045-1046, 1969

Hughston JC, Andrews JR, Cross MJ, et al Classification of knee ligament instabilities Parts I and II J Bone Joint Surg 58A 159-179, 1976

McCormick WL , Bagg RJ, Kennedy Jr, DW, et al:Reconstruction of the posterior cruciate ligament Clin Orthop 118 30-34, 1976

Nicholas JA Report of the Committee on Research and Education Am J Sports Med 6 295-304, 1978

Kennedy JC Classification of knee joint instability Identification and treatment of combined instability of the knee Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco , 1979

Andrews JR Diagnosis and treatment of combined anterolateral-posterolateral instability of the knee Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco, 1979

Marshall JL Knee ligament injuries A diagnostic and therapeutic approach Orthop Clin North Am 8 641-668, 1977

Ellison Aep Distal iliotibial-band transfer for anterolateral rotatory instability of the knee J Bone Jomt Surg 61A 330-337, 1979

10.

Kennedy JC The Injured Adolescent Knee Baltimore, The Williams & Wilkins Co , 1979, pp 1-42

11.

Torg JS Conrad W., Kalen V. Clinical diagnosis of anterior cruciate instability in the athlete Am J Sports Med 4 84-93, 1976

12.

DuToit GT Knee joint cruciate substitution S Afr J Surg 5 25-30, 1967

13.

Clancy Jr, WG , Meiner JG, Marechania RG, et al Anterior and posterior cruciate ligament reconstruction, microangiography, histology, and tensile testing in rhesus monkeys Scientific Exhibit, American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco, 1979

14.

Marshall JL, Fetto JF, Wickiewicz TL An initial long-term follow-up of the quadriceps tendon substitute technique of anterior cruciate ligament reconstruction Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco, 1979

15.

Barfod B. Posterior cruciate ligament—reconstruction by transposition of the popliteus tendon Acta Orthop Scand 42 438, 1971

16.

O'Donoghue DH :Posterior ligament reconstruction Audio-visual program Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco, 1979

17.

Kennedy JC, Grainger RW The posterior cruciate ligament J Trauma 7 367-377, 1967

18.

Lam Sjs: Reconstruction of the anterior cruciate ligament using the Jones procedure and its Guy's Hospital modification. J Bone Joint Surg 50A 1213-1224,1968

19.

Minkoff J. Use of the popliteal tendon for posterior instability reconstruction Audio-visual program, American Academy of Orthopaedic Surgeons Annual Meeting, San Francisco, 1979

20.

Tillberg B. The late repair of torn cruciate ligaments using menisci J Bone Joint Surg 59B 15-19, 1977

21.

Walsh JJ Meniscal reconstruction of the anterior cruciate ligament Clin Orthop 89 171-177, 1972

22.

Collins HR, Hughston JC, DeHaven KE, et al The meniscus as a cruciate substitute J Sports Med 2 11-21, 1974

23.

Slocum DB, Larson RL Pes anserinus transplantation A surgical procedure for control of rotatory instability of the knee J Bone Joint Surg 50A 226-242, 1968