Increasing the Distance between the Posterior Cruciate Ligament and the Popliteal Neurovascular Bundle by a Limited Posterior Capsular Release during Arthroscopic Transtibial Posterior Cruciate Ligament Reconstruction
- 1 May 2007
- journal article
- other
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 35 (5), 787-792
- https://doi.org/10.1177/0363546506297908
Abstract
Background During arthroscopic transtibial posterior cruciate ligament reconstruction, popliteal vessel injury is the most serious complication, and it rarely occurs. Purpose To evaluate the distance change between the posterior cruciate ligament and the neurovascular bundle by limited release of the posterior capsule during arthroscopic posterior cruciate ligament reconstruction. Study Design Controlled laboratory study. Methods The authors performed an arthroscopic posterior cruciate ligament reconstruction procedure on 10 fresh-frozen cadaveric knees. The experimental procedure included 4 steps. Before the procedure and just after each step, angiographic lateral radiographs were checked to find the relationship and the distances between the popliteal artery and the posterior cruciate ligament. Changes in the distances at each step were compared and analyzed by ANOVA with Bonferroni correction. Results The mean distance between the popliteal artery and the tibial insertion of the posterior cruciate ligament increased significantly (from 4.4 ± 3.2 mm to 14.7 ± 4.1 mm) after limited posterior capsular release (P < .01). The distance from the popliteal artery to the midsubstance of the posterior cruciate ligament at the level of the posterior trans-septal portal significantly increased (from 11.3 ± 3.9 mm to 17.6 ± 4.0 mm) just after distension of the knee joint with a pump (P < .01). Conclusion This study showed a significant increase in the distance from the popliteal artery to the posterior cruciate ligament through arthroscopic limited posterior capsular release during arthroscopic transtibial posterior cruciate ligament reconstruction. Clinical Relevance The results of this study support the claim that risk of iatrogenic popliteal vessel injury could be reduced by limited posterior capsular release during arthroscopic transtibial posterior cruciate ligament reconstruction.Keywords
This publication has 22 references indexed in Scilit:
- Arthroscopic Transtibial Posterior Cruciate Ligament Reconstruction with Preservation of Posterior Cruciate Ligament FibersThe American Journal of Sports Medicine, 2006
- Posterior Cruciate Ligament Reconstruction: Double-Loop Hamstring Tendon Autograft Versus Achilles Tendon Allograft—Clinical Results of a Minimum 2-Year Follow-upArthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
- A Biomechanical Comparison of Posterior Cruciate Ligament Reconstructions Using Single- and Double-Bundle Tibial Inlay TechniquesThe American Journal of Sports Medicine, 2005
- Posterior Cruciate Ligament Revision Reconstruction, Part 1The American Journal of Sports Medicine, 2005
- Molecular, cellular and functional imaging of atherothrombosisNature Reviews Drug Discovery, 2004
- Biomechanical Comparison of Tibial Inlay versus Transtibial Techniques for Posterior Cruciate Ligament ReconstructionThe American Journal of Sports Medicine, 2004
- Arthroscopic Posterior Cruciate Ligament Reconstruction with Quadriceps Tendon AutograftThe American Journal of Sports Medicine, 2004
- Proximity of the posterior cruciate ligament insertion to the popliteal artery as a function of the knee flexion angleArthroscopy: The Journal of Arthroscopic & Related Surgery, 2000
- Posterior trans-septal portal for arthroscopic surgery of the knee jointArthroscopy: The Journal of Arthroscopic & Related Surgery, 2000
- Arthroscopic assisted PCL reconstruction: A technical note on potential neurovascular injury related to drill bit configurationArthroscopy: The Journal of Arthroscopic & Related Surgery, 1993