Performance of an athlete with straight posterior knee instability

Abstract

Isolated posterior ligamentous insufficiency of the knee frequently terminates an athlete's career and may even adversely affect the performance of tasks of daily living. Return to competitive athletics following surgical reconstruction for posterior instability is un usual. The pathophysiology of the lesion and a bio mechanical analysis are discussed. A case report of an athlete with a ruptured posterior cruciate ligament who is presently successfully competing in profes sional football is also presented. Rigorous quantitative techniques were employed to document the compen satory mechanisms involved. These consisted of ex tremely strong quadriceps muscles contracting much earlier than normal in the gait cycle. Earlier quadriceps contraction to increase dynamic stability in the knee is able to overcome the instability resulting from the incompetent posterior cruciate ligament.

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References

Hughston JC, Andrews JR, Cross MJ, et al Classification of knee ligament instabilities Part 1 The medial compartment and cruciate ligaments J Bone Joint Surg 58A 159-172, 1976

Hughston JC, Andrews JR, Cross MJ, et al Classification of knee ligament instabilities Part 2 The lateral compartment J Bone Joint Surg 58A 173-179,1976

Smillie IS Injuries of the Knee Joint Fifth edition London , Churchill Livingston, 1978, pp 71-82, 189-252

Frankel VH, Burstein AH, Brooks DB Biomechanics of internal derangements of the knee J Bone Joint Surg 53A 945-962, 1971

Close JR, Todd FN The phasic activity of the muscles of the lower extremity and the effect of tendon transfer J Bone Joint Surg 41A 189-208, 1959

Grieve DW, Miller DI, Mitchelson D., et al Techniques for the Analysis of Human Movement London, Lepus Books, 1975, pp 109-149

University of California The pattern of muscular activity in the lower extremity during walking University of California prosthetic development research report Series 2, Issue 25 Berkeley, CA, University of California Press, 1953, pp 3-79

Frankel VH, Burstein AH Orthopaedic Biomechanics Philadelphia , Lea and Febiger, 1970, pp 118-144

Frankel VH Biomechanics of the knee Orthop Clin North Am 2 175-190, 1971

10.

Manquet Pgj Biomechanics of the Knee New York, Springer-Verlag, 1976, pp 20-58

11.

Schulitz KP, Krahl H., Stein WH Late Reconstruction of Injured Ligaments of the Knee New York, Springer-Verlag, 1978, pp 4-21 , 109-114

12.

Ghista DN, Roaf R. Orthopaedic Mechanics, Procedures and Devices, New York , Academic Press, 1978, pp 4-78

13.

Institute of Mechanical Engineers Human Locomotor Engineering London, Harper & Row, 1974, pp 29-63

14.

Joseph J., Battye CK An investigation by telemetering of the activity of some muscles in walking Med Biol Eng Comput 4 125, 1966

15.

Paul JP The effect of walking speed on the force actions transmitted at the hip and knee joints Proc R Soc Med 63 200, 1970