This case presentation discusses a 33-year-old male who presented with pain and instability in his left knee following a motorcycle accident. Examination revealed a complete tear of the posterior cruciate ligament (PCL). An MRI confirmed a grade 1 ACL tear and grade 3 PCL tear with no meniscal injuries. The patient underwent arthroscopic reconstruction of the PCL using a doubled peroneus longus autograft. Post-operatively, the patient was placed in a functional brace and started a rehabilitation protocol focusing on range of motion, quadriceps strengthening, and return to sports at 9 months. The presentation reviews the relevant anatomy, mechanisms of injury, clinical evaluation, treatment options including conservative management and surgical reconstruction techniques for isolated
Acl Reconstruction Surgery In Delhi Dr. Shekhar Srivastav 09971192233DelhiArthroscopy
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ACL Reconstruction Surgery in Delhi by Dr. Shekhar Srivastav - Dr. Shekhar Srivastav is an Orthopedic Surgeon attached to Sant Parmanand Hospital, Delhi with special interest in Knee & Shoulder surgery. After obtaining his M.S. Orthopedics degree he has undergone training in various centers in India and Abroad which has helped him in understanding the Orthopedics problems and their Management. He did his AO/ ASIF fellowship at University Hospital, Salzburg, Austria in 2006 and recieved training in Arthroscopy & Sports Medicine at TUM, Munich (Germany) & Rush Orthopedics Centre, Chicago( USA). He has an experience of more than fifteen years of diagnosing and treating Orthopedics & Trauma patients.
Check Out Details at http://www.delhiarthroscopy.com
Acl Reconstruction Surgery In Delhi Dr. Shekhar Srivastav 09971192233DelhiArthroscopy
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ACL Reconstruction Surgery in Delhi by Dr. Shekhar Srivastav - Dr. Shekhar Srivastav is an Orthopedic Surgeon attached to Sant Parmanand Hospital, Delhi with special interest in Knee & Shoulder surgery. After obtaining his M.S. Orthopedics degree he has undergone training in various centers in India and Abroad which has helped him in understanding the Orthopedics problems and their Management. He did his AO/ ASIF fellowship at University Hospital, Salzburg, Austria in 2006 and recieved training in Arthroscopy & Sports Medicine at TUM, Munich (Germany) & Rush Orthopedics Centre, Chicago( USA). He has an experience of more than fifteen years of diagnosing and treating Orthopedics & Trauma patients.
Check Out Details at http://www.delhiarthroscopy.com
Arthroscopic ACL Reconstruction By Dr Shekhar ShrivastavDelhiArthroscopy
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Arthroscopic Acl Reconstruction By Dr Shekhar Shrivastav.
HOW NORMAL KNEE WORKS ?
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thigh bone(femur), the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Four bands of tissue, the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments connect the femur and the tibia and provide joint stability. The surfaces where the femur, tibia and patella touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to glide freely. Semicircular rings of tough fibrous-cartilage tissue called the lateral and medial menisci act as shock absorbers and stabilizers.
WHAT IS THE ROLE OF ACL ?
ACL along with other ligaments of the knee joint and meniscus provides stability to the knee joint.
WHAT IS LIGAMENT RECONSTRUCTION ( ACL ) ?
Ligament reconstruction involves replacing the torn ligament with a tendon (graft) from your knee and fixing the graft in place with screws. This procedure is performed with the use of the arthroscope. The anterior cruciate ligament (ACL) is the most common ligament requiring reconstruction procedures. The torn ligament is excised arthroscopically and new ligament is prepared by ligament grafts taken from your own body. Bony tunnels are prepared in femur and tibia using specialized instruments through which the new ligament is passed and fixed with special screws. This procedure requires relative rest or leave from your work or studies for about 2-3 weeks after which you will be allowed normal day to day activities.
WHEN CAN THE PATIENT BE AMBULATED AFTER SURGERY ?
The patient can walk from the same evening of the surgery. Initially the patient is advised to walk with a brace and a walking cane. Strengthening and range of motion exercises for the knee are started from the next day. The patient is discharged from the hospital 2nd or 3rd day after surgery. The patient can walk without support by 10-14 days depending on muscle strengthening. Slow Jogging and other strenuous activities are permitted after 3 months and the patient can return to active sports only 8-9 months after surgery.
Torn ACL Reconstructed ACL
For Further Queries contact your Orthopedic Surgeon at
+ 91 9971192233
posterior curciate liagment injury, machanisum of injury, type of injury, special test, associated injuries ti PCL injury, physiotherapy treatment
posteior sag test, posterior drawer test, abduction stress test, adduction stress test, day wie trsetment
Deformity: Itâs the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Arthroscopic ACL Reconstruction By Dr Shekhar ShrivastavDelhiArthroscopy
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Arthroscopic Acl Reconstruction By Dr Shekhar Shrivastav.
HOW NORMAL KNEE WORKS ?
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thigh bone(femur), the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Four bands of tissue, the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments connect the femur and the tibia and provide joint stability. The surfaces where the femur, tibia and patella touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to glide freely. Semicircular rings of tough fibrous-cartilage tissue called the lateral and medial menisci act as shock absorbers and stabilizers.
WHAT IS THE ROLE OF ACL ?
ACL along with other ligaments of the knee joint and meniscus provides stability to the knee joint.
WHAT IS LIGAMENT RECONSTRUCTION ( ACL ) ?
Ligament reconstruction involves replacing the torn ligament with a tendon (graft) from your knee and fixing the graft in place with screws. This procedure is performed with the use of the arthroscope. The anterior cruciate ligament (ACL) is the most common ligament requiring reconstruction procedures. The torn ligament is excised arthroscopically and new ligament is prepared by ligament grafts taken from your own body. Bony tunnels are prepared in femur and tibia using specialized instruments through which the new ligament is passed and fixed with special screws. This procedure requires relative rest or leave from your work or studies for about 2-3 weeks after which you will be allowed normal day to day activities.
WHEN CAN THE PATIENT BE AMBULATED AFTER SURGERY ?
The patient can walk from the same evening of the surgery. Initially the patient is advised to walk with a brace and a walking cane. Strengthening and range of motion exercises for the knee are started from the next day. The patient is discharged from the hospital 2nd or 3rd day after surgery. The patient can walk without support by 10-14 days depending on muscle strengthening. Slow Jogging and other strenuous activities are permitted after 3 months and the patient can return to active sports only 8-9 months after surgery.
Torn ACL Reconstructed ACL
For Further Queries contact your Orthopedic Surgeon at
+ 91 9971192233
posterior curciate liagment injury, machanisum of injury, type of injury, special test, associated injuries ti PCL injury, physiotherapy treatment
posteior sag test, posterior drawer test, abduction stress test, adduction stress test, day wie trsetment
Deformity: Itâs the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? â The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years â 64.8%, 20 years â 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP â more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0âN12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0âN12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2â3 criteria; moderate AUD: 4â5 criteria; severe AUD: 6â11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
Itâs work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMENâS HEALTH: FERTILITY PRESERVATION
- WHATâS NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMENâS CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. Thatâs why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminateâŠDr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMENâS CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. Thatâs why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminateâŠDr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Patient History
âą 33 Year Old Male presented to us in OPD with C/O
Pain & Instability of Left Knee.
âą Pain & Instability started 3 months back after RTA
(Bike vs Cart).
âą Initially managed conservatively.
âą Both complaints increased progressively over
time.
âą Pain was aggravated on walking & excessive
R.O.M.
âą Complains about leg sagging & giving way
posteriorly while climbing stairs.
3. EXAMINATION
âą 6 cm linear horizontal scar mark over anterior
shin.
âą No swelling or tenderness.
âą Posterior Drawer test â Positive (Grade III)
âą Sagging of Tibia â Positive.
âą Quadriceps Active Test â Positive.
âą Lachman Test â False positive
âą Joint opening on varus stress < 1 cm
14. âą GRAFT SITE âą KNEE ROM
2 weeks Follow up, (No active complaints)
15. WITH FUNCTIONAL (JACK,S ) BRACE ON
Allows 90 degree
Of knee flexion
And stability for pain free
Gait during first 4 weeks
16. REHABILITATION
PROTOCOL
âą ACTIVE ASSISTED ROM FIRST 2
WEEKS
âą FUNCTIONAL BRACE ON FOR 4
WEEKS (limits ROM to 90
Degrees)
âą FULL WEIGHT BEARING after 2
weeks
âą TARGET ROM 90 Degrees
during first 4 weeks (Avoids
stress on Graft)
âą Quadriceps strengthening
(Agonist of PCL)
âą Hamstring Strengthening (3
Months)
âą Return to Sports Specific
Training 6 Months
âą SPORTS at 9 MONTHS
17. LITERATURE
Arthroscopic Transtibial PCL Reconstruction:
Surgical Technique and Clinical Outcomes,
Curr Rev Musculoskelet Med. 2018 Jun; 11(2): 307â315
Double bundle versus single bundle
reconstruction in the treatment of posterior
cruciate ligament injury: A prospective
comparative study
2019 , Vol, 53, Issue : 2, Page : 297-30
Arthroscopic Posterior Cruciate Ligament
Reconstruction With Remnant Preservation
Using a Posterior Trans-septal Portal,
Arthrosc Tech. 2017 Oct; 6(5): e1465âe1469.
18. TEAMWORK MAKES THE DREAMWORK
1ST ARTHROSCOPIC PCL
RECONSTRUCTION AT
ALLIED HOSPITAL FSD
19. Literature
Posterior Cruciate Ligament (PCL) primarily restrains posterior
translation of tibia throughout the range of knee flexion, also has
been found to serve as a secondary restraint to internal & external
rotation.
20. Anterolateral And Posteromedial Bundles Of The Ligament
ï The PCL Has A Broad Attachment To The Lateral
Surface Of The Medial Femoral Condyle.
ï Passes Downwards
ï Average length is 38 mm.
ï Average width 13 mm.
21. POSTERIOR CRUCIATE LIGAMENT ANATOMY
Most important in extension of the knee = POSTEROMEDIAL
BUNDLE
Most important in flexion of the knee = ANTEROLATERAL
BUNDLE
22. âąBoth anterolateral and posteromedial bundles.
TIBIAL ATTACHMENT OF PCL
It Inserts into a narrow area approximately 1 to 1.5 cm below the posterior edge
of the tibia in a depression between the medial and lateral tibial plateau
23. âąThe PCL is stronger than the anterior
cruciate ligament (ACL) in specimens of
similar age.
âąIsolated PCL rupture often does
not lead to disabling instability,
despite the strength of the
damaged structure.
âą The mensciofemoral ligament arising
distal to the PCL and Ending in the
posterior horn of the lateral meniscus.
POSTERIOR CRUCIATE LIGAMENT FACTS
27. TYPES OF INJURIES
Acute isolated PCL injury
Uncommon, diagnosis is easily missed , with mild
symptoms
Acute combined injury to the posterolateral corner and PCL.
The common peroneal nerve is at risk from injury to
the lateral complex
28. TYPES OF INJURIES
Chronic isolated PCL injury
Instability in 50% , giving away in 25%
more than 50 % return to daily activites with no
complaint
Chronic combined injury to the posterolateral corner and PCL
more severe with a more significant history of
instability and pain.
30. CLINICAL EVALUATION
CLINICAL PICTURE:
Unlike ACL Injury , Patient of PCL injury is not often aware of his injury
at time of disrupton.
PATIENT SUFFER OF:
1. Pain (Specially on walking downstairs)
2. Instability
3. Swelling due to knee effusion
32. POSTERIOR DRAWERâS TEST
Most accurate test for
PCL injury examination
Normally, the medial tibial plateau lies 1 cm in front of the
anterior aspect of the medial femoral condyle.
33. Grade Posterior Translation Tibial Position
With posterior drawer
0 <5 mm Normal knee
1+ 5-10 mm Tibial plateau still remains
anterior to femoral condyles
2+ 10-15mm Tibial plateau even with
femoral condyles
3+ >15 mm Tibial plateau posterior to
femoral condyles
34. THE QUADRICEPS ACTIVE TEST
⹠The knee is placed at 60° of flexion
âą The examiner holds pressure on
the foot
âą The patient is asked to contract
the quadriceps isometrically.
The Quadriceps Active Test
In the case of a complete rupture of the PCL, the
quadriceps contraction achieves a dynamic reduction
of the posterior displacement of the
35. LACHMANâS TEST
Fig. 9.
In PCLinjury, The
tibia may assume at
naturally posterior
position may give a
False positive
Lachmanâs Test
15% Of Patients underwent
unnecessary ACL reconstruction
36. INVESTIGATIONS
X-RAY
On Stress Radiography Posterior translation of 8 mm or more is
indication of complete rupture.
MRI
MRI studies are more reliable for diagnosis of PCL
tears than for ACL
39. CONSERVATIVE TREATMENT
The aim of the conservative therapy is to regain 90%
of the quadriceps and hamstring strength compared to
healthy side
Treatment steps:
A.Bracing
B.Quadriceps conditioning
C.Proprioceptive training
D.Specific sports re-programmation
41. SURGICAL TREATMENT
Indications:
âą High grade injuries (grade 3).
âą Any PCL injury with other associated injuries.
âą Any bony avulsion ( internal fixation should be used if
the fragments is large )
âą Reconstruction is preferable if small fragments.
âą Chronic lesion : according to symptoms and disability
and respond to conservation
42. SURGICAL TREATMENT
PCL reconstruction has major controversy
1. Tibial fixation (posterior tibial inlay vs. Tibial tunnel)
1. Graft bundle (double bundle vs. Single bundle)
2. Femoral insertion (location/angle of fixation )
3. Meniscofemoral ligaments (are they significant?).
43. SURGICAL TREATMENT
Goals of surgery
1. Restore native PCLAnatomy.
2. Restore native Anterior tibial stepoff.
3. Restore native Restraint on posterior
tibial displacement.
44. SURGICAL TREATMENT
Types of Graft
Single bundle
Double bundle
1. ALLOGRAFT
âą Deep- frozen bone âpatellar tendon- bone graft
âą Achilles tendon graft with bone on one end.
2. AUTOGRAFT
âą Patellar Tendon
âą Peroneus Longus
âą Quadriceps Tendon
âą Hamstrings Tendon
46. SURGICAL TREATMENT
A combined acute lesion of the posterolateral structure
âą The repair must be done within the first 3 weeks after the
injury.
âą The surgical management of displaced avulsion fractures
will Usually result in a favourable outcome.
47. âą Suture or screw
fixations are an
appropriate method with
a posterior surgical
approach for cases
where there is a large
bony fragment.
48. SINGLE BUNDLE TECHNIQUE
âą For tibial tunnel , insert the
guide(arthrex drill system)
through the anteromedial port
and pass it through the notch.
âą Orient the drill guide about 60
degrees to the articular surface
of tibia, just inferior and
medial to tibial tuberosity.
âą The femoral physiometric point
is 8mm proximal to articular
cartilage at 1-oâclock on the
right knee and 11 o clock on
left.
Risk of failure due to sharp angulation
âkiller curveâ
SURGICAL TREATMENT
Isolated PCL LESION
50. SURGICAL TREATMENT
Double Bundle Technique :
The double- tunnel technique practically and
biomechanically provides the best stability and better fill the
large PCL footprint.