후십자인대 재건술의 임상적 고찰 - 골슬개건골을 이용한 - = Reconstruction of the Posterior Cruciate Ligament

다국어 초록 (Multilingual Abstract)

The posterior cruciate ligament(PCL) is the most important ligament of the knee joint because of its cross section area, tensile strength and location in the central axis of the knee(Hughston et al. 1976, Kennedy 8r, Grainger 1967). Butler et al. (1980) demonstrated that it provides 95 % of the total restraint to posterior displacement of the tibia. We diagnosed and reconstructed sixteen cases with the injury of the PCL by the modified Clancy method. Twelve of sixteen patients with a follow up of eight months to five years(average twenty three months) were evaluated. Seven patients were augmented with Kennedy LAD. The subjective, objective and functional assessment of the knee made according to the criteria of Hughston and Degenhardt(1982). The incidence of the injury af the PCL was 25 % in one hundred seventy one knee ligament injuries. The injuries of medial collateral ligament were combined most fre- quently. 1. The objective and functional results were good in nine and fair in three. 2. The instability of the knee was measured as difference between the injured side and the opposite one. The difference is 7 to 8 mm in three and less than 5 mm in nine of twelve patients. 3. Seven patients were augmented with Kennedy LAD. Three patients were received arthroscopic adhesiolysis due to limitation of motion of the knee. Six patients were examined by arthroscopy and all of them had synovial avergrowth and well vascularization at intercondylar notch. We suggest that the reconstruction of the PCL is necessary when the posterior displacement is more than 1 or 1.5 cm, ache on descending stairs and some discomfort in usual life of the young patients. Augmentation of Kennedy LAD helps early motion of the knee and takes up part of the load to the grafted patellar tendon. But further follow up is required to evaluate the stress shielding effect of Kennedy LAD and the grafted patellar tendon.