Posterior subluxations of the medial and lateral tibiofemoral compartments
We report for the first time the abnormal increases in posterior subluxation of the medial and lateral tibial plateaus after sectioning the posterolateral structures and posterior cruciate ligament. We applied specific forces and moments to the knees of seven cadaveric whole lower limbs and measured...
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Veröffentlicht in: | The American journal of sports medicine 1993-06, Vol.21 (3), p.407 |
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Zusammenfassung: | We report for the first time the abnormal increases in posterior subluxation of the medial and lateral tibial plateaus after
sectioning the posterolateral structures and posterior cruciate ligament. We applied specific forces and moments to the knees
of seven cadaveric whole lower limbs and measured the position of the tibia at which the ligaments and the geometry of the
joint limited motion.
Removal of only the posterolateral structures resulted in an average increase in posterior translation of the lateral tibial
plateau of 8.0 mm (range, 5.7 to 10.6) at 30° of flexion over the intact state (P < 0.01), but no significant increase at
90° of flexion (mean, 2.7 mm). Knees with underlying physiologic cruciate ligament laxity (high anterior/posterior displacement
in the intact knee) had the greatest lateral tibial plateau subluxation (P < 0.01). There was no abnormal posterior translation
of the medial tibial plateau. After sectioning the poste rior cruciate ligament and the posterolateral structures, statistically
significant increases in posterior translation of both the medial and lateral tibial plateaus occurred at 30° and 90° of flexion
(P < 0.01). The increase in posterior translation of the lateral tibial plateau over the intact state averaged 17.8 and 23.5
mm at 30° and 90° of flexion, respectively; for the medial tibial plateau this increase averaged 7.6 and 12.3 mm at 30° and
90° of flexion, respectively.
The diagnosis of abnormal tibiofemoral rotatory sub luxations requires knowledge of the anteroposterior direction and magnitude
of each tibial plateau under both low flexion and high flexion knee angle positions. |
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ISSN: | 0363-5465 1552-3365 |
DOI: | 10.1177/036354659302100314 |