Operative Orthopadie und Traumatologie · 2025
[Augmented reconstruction of the posterior cruciate ligament for acute and chronic posterior instability].
Аннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Höger Svenja, Siebenlist Sebastian, Mehl Julian, Achtnich Andrea
Аннотация
OBJECTIVE: Anatomical reconstruction of the posterior cruciate ligament (PCL) with suture tape augmentation to enhance primary stability.
INDICATIONS: Acute or chronic PCL ruptures, either isolated or as part of multiligamentous injuries, in cases of symptomatic instability or failure of conservative treatment.
CONTRAINDICATIONS: Fixed posterior drawer, active infection, bony avulsion.
SURGICAL TECHNIQUE: Supine positioning, use of standard portals for arthroscopic PCL reconstruction. Femoral and tibial tunnels are created using a targeting device following preparation of the insertion sites. The hamstring graft is augmented with nonresorbable suture tape. The augmentation suture is fixed separately using a suture anchor under continuous anterior drawer stress. Graft fixation is performed via extracortical device at the femur and with an interference screw at the tibia.
POSTOPERATIVE MANAGEMENT: Six weeks of extension bracing with posterior tibial support, worn 24 h/day, and 20 kg partial weight-bearing. This is followed by 6 weeks of continued mobile bracing with posterior tibial support and progressive mobilization and load increase, accompanied by physiotherapy.
RESULTS: Biomechanical and early clinical studies suggest promising benefits of augmentation for stability and function, though robust long-term data are still lacking.
INDICATIONS: Acute or chronic PCL ruptures, either isolated or as part of multiligamentous injuries, in cases of symptomatic instability or failure of conservative treatment.
CONTRAINDICATIONS: Fixed posterior drawer, active infection, bony avulsion.
SURGICAL TECHNIQUE: Supine positioning, use of standard portals for arthroscopic PCL reconstruction. Femoral and tibial tunnels are created using a targeting device following preparation of the insertion sites. The hamstring graft is augmented with nonresorbable suture tape. The augmentation suture is fixed separately using a suture anchor under continuous anterior drawer stress. Graft fixation is performed via extracortical device at the femur and with an interference screw at the tibia.
POSTOPERATIVE MANAGEMENT: Six weeks of extension bracing with posterior tibial support, worn 24 h/day, and 20 kg partial weight-bearing. This is followed by 6 weeks of continued mobile bracing with posterior tibial support and progressive mobilization and load increase, accompanied by physiotherapy.
RESULTS: Biomechanical and early clinical studies suggest promising benefits of augmentation for stability and function, though robust long-term data are still lacking.