HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Strobel, M. J. Articles by Eichhorn, H.-J. Search for Related Content PubMed PubMed Citation Articles by Strobel, M. J. Articles by Eichhorn, H.-J. Related Collections Knee Nonoperative

Fixed Posterior Subluxation in Posterior Cruciate Ligament-Deficient Knees

Diagnosis and Treatment of a New Clinical Sign

Michael J. Strobel, MD^*,, Andreas Weiler, MD, Martin S. Schulz, MD^*, Kai Russe, MD^* and H.-Jürgen Eichhorn, MD^*

^* Orthopädische Gemeinschaftspraxis, Straubing, Charité, Campus Virchow Clinic, Humboldt-University, Berlin, Germany
Trauma & Reconstructive Surgery, Sports Traumatology & Arthroscopy Service, Charité, Campus Virchow Clinic, Humboldt-University, Berlin, Germany

Address correspondence and reprint requests to Michael J. Strobel, MD, Orthopädische Gemeinschaftspraxis, Hebbelstrasse 14a, 94315 Straubing, Germany

Among 248 patients seen for posterior cruciate ligament insufficiency, 109 (44%) had fixed posterior subluxation of the tibia, defined as a condition in which posterior sag could not be reduced to a neutral position, as evidenced by posterior tibial displacement of 3 mm or more on anterior stress radiographs at 200 N. The mean fixed posterior displacement was 6.23 mm (range, 3 to 20). The fixed posterior subluxation was divided into three grades: I, 3 to 5 mm (57.8%); II, 6 to 10 mm (33.9%); and III, more than 10 mm (8.3%). Comparison of the 109 study patients with the 139 control patients revealed a history of a failed posterior cruciate ligament operation or of a patellar tendon harvest, male sex, and a long history of posterior cruciate ligament insufficiency as significant risk factors for the development of a fixed posterior subluxation. After patients were treated with a posterior tibial support brace, the fixed posterior subluxation could be reduced to a mean of 2.58 ± 5.22 mm within an average treatment period of 180 days. Fixed posterior subluxation can be detected in patients with posterior cruciate ligament deficiency by anterior and posterior stress radiographs and should be addressed before posterior cruciate ligament reconstruction to prevent early overloading of the graft.

This article has been cited by other articles:

				J. R. Giffin, K. J. Stabile, T. Zantop, T. M. Vogrin, S. L-Y. Woo, and C. D. Harner Importance of Tibial Slope for Stability of the Posterior Cruciate Ligament Deficient Knee Am. J. Sports Med., September 1, 2007; 35(9): 1443 - 1449. [Abstract] [Full Text] [PDF]

				M. Logan, A. Williams, J. Lavelle, W. Gedroyc, and M. Freeman The Effect of Posterior Cruciate Ligament Deficiency on Knee Kinematics Am. J. Sports Med., December 1, 2004; 32(8): 1915 - 1922. [Abstract] [Full Text] [PDF]

				L. C. Almekinders, R. Pandarinath, and F. T. Rahusen Knee Stability Following Anterior Cruciate Ligament Rupture and Surgery. The Contribution of Irreducible Tibial Subluxation J. Bone Joint Surg. Am., May 1, 2004; 86(5): 983 - 987. [Abstract] [Full Text] [PDF]

				C. B. Ma, A. Kanamori, T. M. Vogrin, S. L-Y. Woo, and C. D. Harner Measurement of Posterior Tibial Translation in the Posterior Cruciate Ligament-Reconstructed Knee: Significance of the Shift in the Reference Position Am. J. Sports Med., November 1, 2003; 31(6): 843 - 848. [Abstract] [Full Text] [PDF]