Abstract:
Posterior cruciate ligament (PCL) injuries are a rare form of knee injury often seen in the setting of high energy polytraumas; however, these injuries can occur in isolation as well. Often, the posterolateral corner (PLC) is involved, which imparts further posterior translational and rotational instability to these injuries. While non-operative management is certainly a reliable option for low grade isolated PCL tears, high grade injuries with concomitant PLC involvement, additional intra-articular pathologies requiring operative management, multiligamentous injuries, or patients who have failed non-operative management require PCL repair or reconstruction. The current review focuses on the many facets of PCL reconstruction, including single versus double bundle reconstruction, tibial slope implications, graft selection, multiligamentous injury considerations, tunnel management, and onlay versus inlay tibial footprint creation. We conclude with a proposed algorithm in the management of this injury.
摘要:
后交叉韧带(PCL)损伤是一种罕见的膝关节损伤,常见于高能量多发伤的背景下;然而,这些伤害也可以单独发生。通常,涉及后外侧角(PLC),赋予这些损伤进一步的后平移和旋转不稳定性。虽然非手术管理无疑是低级别隔离PCL撕裂的可靠选择,伴随PLC参与的高级别损伤,需要手术治疗的其他关节内病变,多韧带损伤,或非手术治疗失败的患者需要PCL修复或重建。当前的审查集中在PCL重建的许多方面,包括单束重建和双束重建,胫骨坡度影响,移植物选择,多韧带损伤的考虑,隧道管理,以及高嵌体与镶嵌胫骨脚印的创建。最后,我们提出了一种处理这种伤害的算法。