Navigation Links
The 'Other' Cruciate Ligament: Newer Treatments for PCL Tears
Date:7/1/2009

New study reports on posterior cruciate ligament treatment options, but investigation is not over

ROSEMONT, Ill., July 1 /PRNewswire-USNewswire/ -- While major advances have been made in the understanding of posterior cruciate ligament (PCL) anatomy and reconstruction, a literature review published in the July 2009 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) finds that there must be continued advances in basic science research in order to determine the best course of treatment for those with PCL injuries.

"An ACL (anterior cruciate ligament) tear is an injury of instability; a PCL tear is an injury of disability," said study author Matthew Matava, M.D., Associate Professor, Department of Orthopedic Surgery, Washington University School of Medicine, in Chesterfield, Missouri. "With a PCL injury, your knee won't buckle on you tomorrow, but in a few months or years it may become painful and not as strong or stable as it was prior to the injury. PCL tears are less frequently discussed because they are often left undiagnosed and the patient does not seek treatment for what they assumed was a mild injury."

PCL injuries are assessed by grades:

  • Grade 1: Partial tear (non-surgical treatment options recommended)
  • Grade 2: Isolated, near complete tear (non-surgical treatment options recommended)
  • Grade 3: Complete PCL torn, with other ligament injuries (surgery often recommended, but not always)

Two newer surgical options, along with one traditional method, are currently used to treat Grade 3 injuries:

  • Traditional: One-bundle bone graft passed through a tunnel in the tibia (shin bone). One-bundle grafts are made thicker than two-bundle grafts, but may not be as effective because they attach at a single point.
  • Newer: Two-bundle graft (studied for the past 10 years). Two-bundle grafts use thinner individual grafts, but their total graft volume is thicker. They may be more effective than one-bundle grafts because they attach at two different points.
  • Newer: Inlay reconstruction is an approach whereby a graft is screwed into the back of the tibia avoiding a tunnel through the front of the tibia.

According to Dr. Matava, basic science data suggests that it is favorable to use a two-bundle graft over a one-bundle graft, and that an inlay reconstruction is preferable to a graft passing through a tibial tunnel. Inlay reconstruction is different, he says, because the graft does not get stretched around the tibial tunnel and is prevented from stretching out and/or fraying.

"I like this procedure because I have had improved results compared to prior patients of mine that underwent the traditional method with the graft placed through the tibial tunnel," said Dr. Matava. "Additionally, there is biomechanical evidence that the benefits I have noticed are real." There have not been any randomized prospective studies to date, however, comparing the two methods.

Some orthopaedic surgeons, however, believe these procedures are more complicated and therefore more risky; they also disagree on how much tension to use on the graft. If a patient has a PCL injury, the orthopaedic surgeon should first determine the level of injury in order to decide on the best treatment option. Because PCL surgery is technically challenging, a patient needing surgery should seek out an orthopaedic surgeon with experience performing PCL reconstructions.

"Although we believe the newer treatments are better, we still must prove it," said Dr. Matava. "In order to do that, we must continue with our research, and follow patients over the course of several years to determine whether their treatments were successful."

About the PCL

The PCL is a ligament that prevents the shin bone from moving backwards, and PCL injuries occur most frequently in individuals involved in motor vehicle accidents when the knee is bent and the shin forcefully strikes the dashboard. Athletes also experience PCL tears when they fall on the front of their knee, causing it to bend back.

Injuries to the PCL should not be confused with ACL injuries. Nearly 200,000 ACL surgeries are performed in the U.S. each year; PCL surgeries are estimated to be approximately 20 times less common.

Disclosure: Matthew Matava, MD or a member of his immediate family serves as a paid consultant to or is an employee of ISTO Technologies and Schwartz Biomedical, and has received research or institutional support from Breg. Neither of the other authors of the study or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Evan Ellis, M.D. and Brian Gruber, M.D.

JAAOS

AAOS


'/>"/>
SOURCE American Academy of Orthopaedic Surgeons
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Another Reason Not to Smoke While Pregnant: Birth Defects
2. FDA Warns of Codeine Risk for Some Nursing Mothers
3. More than two-thirds of sexually active NYC youth use condoms, but other forms of birth control lag
4. One Species Genome Found Within Another
5. Claim Filed Against the Company and Nine Other Defendants in the Haifa Magistrates Court
6. Family-based treatment more effective than supportive psychotherapy in treating bulimia
7. Mother and Daughter Create Lead-Free/Safe Bibs and Solve Messy Mealtime Problems
8. Mothers Know Best: NFL Moms Team With Eddie George to Showcase a Better Way to a Healthier Lifestyle
9. Eat Seafood, See Weight Loss: Recent Study Finds Another Reason to Eat Seafood for a Fit Lifestyle
10. DTI Medical Corporation Announces Reverse Split and Other Corporate Developments
11. Chemotherapy may be culprit for fatigue in breast cancer survivors
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/31/2016)... ... May 31, 2016 , ... Interest is on the rise ... and as an orthogonal tool for RNAi hit validation. A key reason may be ... RNAs—allows rapid generation of CRISPR RNA (crRNA) collections in arrayed formats. , ...
(Date:5/31/2016)... ... May 31, 2016 , ... In a recent interview on The Greenburgh Report ... Rochelle, NY-based WVOX (1460 AM), leading medical insurance advocate Adria Goldman Gross ... “modern medical money maelstrom.” , During the interview with Mr. Feiner that aired ...
(Date:5/31/2016)... IL (PRWEB) , ... May 31, 2016 , ... ... multichannel marketing services firm and statement solutions provider, for the tenth ... in the May 2016 issue of Advertising Age, and SourceLink ranked eighteenth in ...
(Date:5/31/2016)... ... ... Super Powder, a supplement produced by Prox Formulas for providing protein ... to transform the nutritional supplement industry by providing a safe, natural approach to enhanced ... (BCAA), alkaline minerals, wheat grass, digestive enzymes, Omega 3’s, Vit D3, Vit A, B1, ...
(Date:5/30/2016)... ... May 30, 2016 , ... Zane Benefits, the leader ... an original infographic, " Health Benefits Reimbursement Compliance Timeline ." , The ... complies with various federal regulations and reforms. , Navigating the new health reforms ...
Breaking Medicine News(10 mins):
(Date:5/30/2016)... , May 30, 2016 Eye ... parents of premature babies to seek an eye examination ... blinding condition     Moorfields Eye Hospital ... in London , has identified premature babies as ... problems, because of their particular vulnerability to retinopathy of prematurity (ROP). ...
(Date:5/27/2016)... According to the 2016 report, ... ambulatory blood pressure monitoring system market growth. With aging, ... to respond to different pressure rates, leading to hypertension ... various cardiovascular disorders such as heart failure, stroke, coronary ... growing in prevalence each year. WHO estimates that 17 ...
(Date:5/27/2016)... , May 27, 2016 Amarantus BioScience ... on developing products for Regenerative Medicine, Neurology and Orphan Diseases, today ... be presenting at two upcoming investor conferences: SeeThru ... Third Avenue, New York City , NY ... Marcum MicroCap Conference   Where: Grand Hyatt ...
Breaking Medicine Technology: