– Femoral Tunnel: – goal is to re-create the large anterolateral band of the PCL, which tightens in flexion; – see anatomy of PCL – cortical entry site: – small skin incision is made w/in Langer’s lines, which overlies the vastus medialis oblique insertion into … Read more
– Graft Selection: – bone patella bone allograft or achilles tendon allograft; – if achilles tendon is used, the free end is secured w/ a locked whip stitch (Krackow stitch); – in the report by Fanelli et al. 1996, there was no disadvantage … Read more
– Tibial Tunnel: – saftey measures: – surgeons who do not perform this operation frequently should use flouroscopy for this tunnel; – apply Jacobs chuck for a preset distance on the guidewire to make it less likely for the wire to pass … Read more
– Discussion: – Anatomy and Function of PCL: – mechanism of injury: – fall on a flexed knee with plantar flexed ankle; – associated injuries: – ACL and collateral ligament injury (knee dislocation); – when PCL injury occurs w/ MCL … Read more
– Discussion: – dx is made when there is posterior instability on exam and a bone fragment was seen on x-ray; – MRI allows determination of the anatomy of the tear (ie femoral or tibial origin); – tibial avulsions: – tibial avulsions … Read more
– Discussion: (see TKR menu) – posterior capsular ligament has three parts; (see posterior oblique ligament) – one overlies each femoral condyle and a third, shorter section passes between them; – these three parts normally limit extension provided that the depths of the prosthetic surfaces and the cement are … Read more
– See: Posterior Approach for Pelvic Frx – Indications for Use: – isolated posterior wall & posterior column frxs; – allows access to posterior column and posterior wall only, but exposure is limited proximally by superior gluteal vessels and greater trochanter; – isolated transverse frx (as well … Read more
– Discussion: – S shaped skin incision is made, extending along the posterior border of biceps and its tendon on the upper lateral side of popliteal fossa, then transversely across the fossa and finally along lower medial side of fossa posterior to semitendinosus tendon; – skin flaps are retracted and the deep fascia is incised … Read more
– See: – Associated Transverse and Posterior Wall Frx – Classification and Column Theory – Discussion: – most common type of acetabular frx (up to 50% of acetabular fractures will contain a posterior wall fragment); – posterior wall frxs involve the posterior articular surfaces, often w/ retroacetabular … Read more
– Radiographic Evaluation: – hyper-extension lateral view: – allows assessment of percentage of impingement by intercondylar roof; – a line is drawn thru the center of the tibial tunnel and a line is drawn tangential to the slope of the intercondylar roof; … Read more