Browse
Submit Data
Databases
API
Help

Dataset Information

21 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Transmedial All-inside TriLink Posterior Cruciate Ligament Reconstruction.

ABSTRACT: Posterior cruciate ligament (PCL) injuries usually constitute part of a multiligament injury. Isolated PCL injuries account for only approximately 3% of all ligament injuries. No consensus on optimal surgical reconstruction exists. The PCL is a double-bundle structure that functions in an anisometric manner. Biomechanical studies have shown that re-creating the PCL femoral double-bundle configuration provides greater stability. We present a 3-socket approach for an anatomic "all-inside" double-bundle PCL reconstruction using our preferred option of a FiberTape (Arthrex, Naples, FL)-reinforced peroneus longus allograft fashioned to create a trifurcate graft: the TriLink technique. Cortical suspensory fixation devices are used, allowing differential tensioning of the anterolateral and posteromedial bundles. This enables more accurate replication of the native PCL and its biomechanical properties.

SUBMITTER: Yasen SK

PROVIDER: S-EPMC5797281 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Transmedial All-inside TriLink Posterior Cruciate Ligament Reconstruction.

Yasen Sam K SK Borton Zakk M ZM Britton Edward M EM Palmer Harry C HC Wilson Adrian J AJ

Arthroscopy techniques 20171016 5

Posterior cruciate ligament (PCL) injuries usually constitute part of a multiligament injury. Isolated PCL injuries account for only approximately 3% of all ligament injuries. No consensus on optimal surgical reconstruction exists. The PCL is a double-bundle structure that functions in an anisometric manner. Biomechanical studies have shown that re-creating the PCL femoral double-bundle configuration provides greater stability. We present a 3-socket approach for an anatomic "all-inside" double-b ...[more]

PMID: 29416973

Similar Datasets

Double-bundle "all-inside" posterior cruciate ligament reconstruction.

Project description:The procedure for repairing the posterior cruciate ligament (PCL) has a steep learning curve and entails numerous difficult steps during surgery, because of the proximity of the neurovascular bundle, difficult passage of the graft through the posterior capsule, and risk of poor tibial fixation because of the long intramedullary trajectory of the graft. The use of instruments for retrograde reaming and a new device for adjustable cortical suspensory fixation allows for a safe, reproducible all-inside double-bundle PCL reconstruction by simplifying these difficult steps. We used anterior tibial allograft or hamstring autograft together with adjustable suspensory fixation devices that allow tensioning (after fixation) of the posterolateral bundle in extension and the anteromedial bundle in flexion.

| S-EPMC3678623 | biostudies-literature

All-Inside Posterior Cruciate Ligament Reconstruction With a GraftLink.

Project description:Posterior cruciate ligament (PCL) reconstructions are challenging surgeries. Recent advances have included double-bundle PCL, arthroscopic inlay, and all-inside techniques. This technical note presents an anatomic, single-bundle, all-inside PCL reconstruction with an anterior tibialis allograft GraftLink construct. The surgery was performed with FlipCutter guide pins and ACL TightRope RT. The case involved a 22-year-old woman with an isolated grade 3 PCL tear that had failed nonoperative treatment. The technique described is minimally invasive.

| S-EPMC3716209 | biostudies-literature

All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique.

Project description:Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation.

| S-EPMC4722703 | biostudies-other

Nanoscopic-Assisted Anterior Cruciate Ligament-Posterior Cruciate Ligament Reconstruction.

Project description:Knee arthroscopy has allowed us to continue performing surgeries that are minimally invasive and allow patients to have a quick recovery. Multiligamentous knee reconstruction with regards to the anterior cruciate ligament and posterior cruciate ligament can be done in a minimally invasive matter. Visualization is an issue during this surgery, especially looking in the posterior compartment of the knee. The NanoScope (Arthrex, Naples, FL) continues to provide increased possibilities for orthopaedic surgeons. Our technique provides a less-invasive way to observe the posterior compartment to assist the drilling of the tibial tunnel during the posterior cruciate ligament reconstruction. This technique provides distinct advantages over other treatments.

| S-EPMC8322670 | biostudies-literature

Arthroscopic All-Inside Posterior Cruciate Ligament Reconstruction: Overcoming the "Killer Turn".

Project description:One of the most challenging arthroscopic surgical procedures is posterior cruciate ligament (PCL) reconstruction. PCL injuries account for 20% of all knee ligament-related injuries. These may be isolated or occur as part of poly-ligament injuries. With the possibility of PCL reconstruction with the all-inside technique, there has been a surge in interest in treating PCL injuries. With the PCL being one of the strongest ligaments in the body and a primary restraint to posterior translation of the tibia, the need for PCL reconstruction is being more and more recognized. Surgeons often find it difficult to negotiate the so-called killer turn while attempting arthroscopic PCL reconstruction. We describe the use of the GraftLink graft construct through the posteromedial portal in 7 patients (6 male and 1 female patient) with isolated PCL injuries, which we believe not only allows us to perform the all-inside PCL reconstruction but also does away with the difficulty of the killer turn encountered while performing the arthroscopic PCL reconstruction.

| S-EPMC5021088 | biostudies-other

TransMedial All-Inside Posterior Cruciate Ligament Reconstruction Using a Reinforced Tibial Inlay Graft.

Project description:Surgical reconstruction of the posterior cruciate ligament (PCL) is technically demanding. Potential challenges include visualization of the tibial footprint and drilling of the tibial tunnel without damaging posterior neurovascular structures, as well as graft selection, deployment, tensioning, and fixation. We present a novel TransMedial all-inside arthroscopic technique (technique designed by A. J. Wilson with support from Arthrex) using a single hamstring tendon graft, fixed with adjustable cortical suspensory devices. The technique simplifies the difficult steps encountered during PCL reconstruction and is safe and reproducible. All arthroscopic viewing is accomplished from the lateral portal, and femoral socket preparation is performed from the medial side with specially contoured instruments, which allow accurate marking, measuring, and anatomic positioning of the graft. The quadrupled semitendinosus graft can be augmented with composite polymer tape for increased strength and initial stability. We use outside-in drilling to create retrograde femoral and tibial sockets. Cortical suspensory fixation on the tibial side can be supplemented with anchor fixation. We use an arthroscopic tibial inlay technique that better approximates native knee anatomy. This also avoids the "killer turn," a problem seen in transtibial PCL reconstruction techniques, which theoretically induces graft laxity due to abrasion with cyclic loading. This technique can be further adapted to allow a modified double-bundle or TriLink graft (technique designed by A. J. Wilson with support from Arthrex.).

| S-EPMC3882715 | biostudies-literature

Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction.

Project description:The posterior cruciate ligament (PCL) is known to be the main posterior stabilizer of the knee. Anatomic single-bundle PCL reconstruction, focusing on reconstruction of the larger anterolateral bundle, is the most commonly performed procedure. Because of the residual posterior and rotational tibial instability after the single-bundle procedure and the inability to restore the normal knee kinematics, an anatomic double-bundle PCL reconstruction has been proposed in an effort to re-create the native PCL footprint more closely and to restore normal knee kinematics. We detail our technique for an anatomic double-bundle PCL reconstruction using Achilles and anterior tibialis tendon allografts.

| S-EPMC4886264 | biostudies-literature

Double-Bundle, All-Inside Posterior Cruciate Ligament Reconstruction: A Technique Using 2 Separate Autologous Grafts.

Project description:In a double-bundle posterior cruciate ligament reconstruction, several surgical techniques are available. Compared with other techniques, the advantages of the all-inside technique and cortical suspension devices with variable loop length are that shorter grafts can be used, tendons can be quadrupled, and a double-bundle posterior cruciate ligament reconstruction can be performed with autologous grafts. Furthermore, the all-inside technique provides independent outside-in socket reaming and is soft tissue, cortex, and bone sparing because no full diameter tunnels but sockets are created with a small diameter guide pin, which can transform into a retrograde drill. Sockets could however lead to bottoming out of the grafts at the femoral side and subsequent residual laxity. This can be avoided by using 2 separate grafts that are fixed in 2 femoral sockets before they are independently fixed and tensioned in 1 tibial socket in their corresponding flexion angle. In this technical note, we present a double-bundle, all-inside posterior cruciate ligament reconstruction using 2 separate autologous grafts.

| S-EPMC5124428 | biostudies-literature

Posterior Oblique Ligament Repair Concomitant to Anterior Cruciate Ligament Reconstruction.

Project description:The associated lesion of the posterior oblique ligament (POL) in the setting of anterior cruciate ligament rupture is quite frequent due to the same rotational mechanism. The diagnosis of POL lesions is challenging, and physical examination is delicate; moreover, they can be easily missed on magnetic resonance imaging. Once recognized, POL lesions must be repaired to restore posteromedial corner kinematics. The aim of this Technical Note is to present a safe and effective method for POL repair in the set of an anterior cruciate ligament reconstruction.

| S-EPMC7917300 | biostudies-literature

Inside-out Tibial Tunnel Drilling Technique for All-inside Anterior Cruciate Ligament Reconstruction.

Project description:All-inside anterior cruciate ligament reconstruction passed through a series of modifications over the past 2 decades, maintaining 2 common factors: half tunnels in both the femur and tibia and introduction of the graft into the knee through an arthroscopic portal. One of the disadvantages noted with this technique is the excessive cost of the instrumentation needed to perform it and its economic impact on the health care system. We describe a modification of the original technique, both maintaining the cortical bone in an intact state and avoiding the retrograde drill aiming device.

| S-EPMC5982608 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data