✅ Knee MRI Mastery/Chap 2.ACL and PCL99 (Fig 2-E.32) Graft Tear In PCL Reconstruction: killer turn of the tibial tunnel opening. https://youtu.be/Cd99fDQ6qSAhttps://youtu.be/UgiSgNcqguA1️⃣ Understanding the "Killer Turn" in PCL ReconstructionThe term "killer turn" in posterior cruciate ligament (PCL) surgery describes the sharp, stressful bend that the PCL graft undergoes at the tibial tunnel aperture. This is not a smooth curve but an abrupt angle that can lead to increased graft tension, abrasion, and eventual failure. .. 2024. 4. 29. (Fig 2-E.31) Graft Tear In PCL Reconstruction and Arthrofibrosis https://youtu.be/LGExBkGbODAhttps://youtu.be/UgiSgNcqguAPost-PCL Reconstruction Complications① Recurrent instabilityRecurrent instability is a common complication, possibly due to graft tear/stretching, impingement, or malpositioned tunnels.Graft tears may occur due to new injury or chronic impingement from suboptimal tunnel positioning.MRI signs of graft tear are similar to ACL but have lower s.. 2024. 4. 29. (Fig 2-E.30) Double-bundle PCL reconstruction, Femoral Tunnel Placement https://youtu.be/o7Nvom0S23Qhttps://youtu.be/UgiSgNcqguA✅ Double-Bundle PCL ReconstructionThe double-bundle technique aims better to mimic native PCL for improved posterior stability in flexionBiomechanical studies show superior knee laxity and kinematics restoration compared to single-bundle Potential for excessively restricted residual anteroposterior translationNo significant differences in c.. 2024. 4. 29. (Fig 2-E.29) Femoral Tunnel Placement of PCL Reconstruction https://youtu.be/s1cezFjtZaYhttps://youtu.be/UgiSgNcqguA✅ Posterior Cruciate Ligament (PCL) Reconstruction: Single Bundle Technique1. Anatomy of the PCL Bundles:The anterolateral bundle arises anteriorly from the lateral margin of the medial femoral condyle and extends up to the roof of the intercondylar notch.The posteromedial bundle attaches slightly more medially and posterior to the anterola.. 2024. 4. 29. (Fig 2-E.28) PCL Graft Ligamentization https://youtu.be/oQaqeFP_78ohttps://youtu.be/UgiSgNcqguAPCL graft ligamentization is the process of remodeling and revascularization that a tendon graft undergoes after being used for posterior cruciate ligament (PCL) reconstruction surgery. This process can be divided into three phases:1.Early phase (0-3 months):The graft is avascular (no blood supply)It appears hypointense (dark) on all MRI se.. 2024. 4. 29. (Fig 2-E.27) Treatment of Acute Avulsion Fracture of PCL https://youtu.be/_rcYruLO4Mohttps://youtu.be/UgiSgNcqguAPCL tears typically do not occur alone and are most often associated with multiligamentous knee injuries.✅ Treatment StrategiesHistorically, treatments have ranged from ligament reconstruction to primary repair. Recently, arthroscopic primary PCL repair has emerged as a favorable option due to its minimally invasive nature. This technique p.. 2024. 4. 28. (Fig 2-E.26) PCL Repair https://youtu.be/vsxJzmhoV30 https://youtu.be/UgiSgNcqguA✅ ACL RepairThe ACL often requires reconstruction due to its poor healing capacity after complete tears. However, when the ACL is intact with an associated tibial eminence avulsion fracture, primary repair by reattaching the bone fragment is possible and usually successful. This method applies to avulsion fractures at both the femoral and .. 2024. 4. 28. (Fig 2-E.25) Multiligamentous Injuries Associated with PCL Injuries https://youtu.be/QYpA6UeK6oohttps://youtu.be/UgiSgNcqguA📌Common Associated Injuries with Posterior Cruciate Ligament (PCL) Injury1️⃣ Posterolateral Corner Injuries: Up to 73% of PCL injuries involve damage to the posterolateral corner structures, such as the lateral collateral ligament, popliteus muscle, popliteofibular ligament, biceps femoris muscle, arcuate ligament, and fabellofibular ligam.. 2024. 4. 28. (Fig 2-E.24) Chronic Complete Tear of the PCL - Part 2 https://youtu.be/aXLAu1vhjekhttps://youtu.be/UgiSgNcqguA📌 Diagnosing Chronic PCL Tears1️⃣ : Understanding PCL Appearance on MRIChronic tears of the Posterior Cruciate Ligament (PCL) often present subtle signs that can be challenging to detect on MRI.Studies indicate that nearly 28% of chronic PCL injuries might appear almost normal, while another 44% may demonstrate continuity but with noticeab.. 2024. 4. 28. (Fig 2-E.23) Chronic Complete Tear of the PCL - Part 1 https://youtu.be/Vf85VGRMDPohttps://youtu.be/UgiSgNcqguAChronic posterior cruciate ligament (PCL) injuries can present with various MRI appearances, posing challenges in accurately diagnosing and assessing functional integrity. 📌Key points regarding chronic PCL complete tears:1️⃣Morphological Changes:The chronically injured PCL may appear thickened, elongated, or have a persistently abnormal co.. 2024. 4. 28. (Fig 2-E.22) Posterior Tibial Translation https://youtu.be/FXQinbBujEQhttps://youtu.be/UgiSgNcqguA📌Posterior Tibial TranslationContext: MR imaging has limitations in detecting chronically injured and functionally deficient PCL.Important Finding: Posterior tibial translation is a crucial indicator of persistent PCL deficiency and instability.Measurement Details: A posterior tibial translation of 2 to 2.9 mm measured on the sagittal sequ.. 2024. 4. 28. (Fig 2-E.21) Radiographic Assessment of Posterior Knee Laxity https://youtu.be/fX2nHPARDh0https://youtu.be/UgiSgNcqguA1️⃣ PCL Stress Radiographs in Chronic Injuries:Due to the healing process, MRI examinations in patients with chronic PCL injuries might not fully reveal the extent of the deficiency.Stress radiographs offer a more objective method to assess the PCL's structural integrity.American Journal of Sports Medicine, December 2015; 43(12): 3077-92. 2.. 2024. 4. 27. (Fig 2-E.20) PCL Deficient Knee with Delayed Imaging https://youtu.be/gTRTyD7QyfEhttps://youtu.be/SXRAadVysHchttps://youtu.be/UgiSgNcqguA1️⃣ Chronic PCL Tears: MR Imaging Insights✅MR imaging for chronic PCL injuries is less reliable, often confusing ligament continuity with partial or no tears. Identifying chronic partial tears is difficult, even with clinical indicators.Source: Radiology, Oct 2016; 281(1):23-40.✅ Chronic PCL damage may show ligam.. 2024. 3. 18. (Fig 2-E.19) PCL Bony Avulsion At Tibial Insertion https://youtu.be/l1j_Prh5nTQ https://youtu.be/UgiSgNcqguA✅PCL bony avulsion at the tibial insertionPCL bony avulsion at the tibial insertion occurs in about 10% of cases. It's important to differentiate ligamentous injuries of the PCL from osseous avulsions because osseous avulsions can be treated with primary fixation.Radiology. 2016 Oct;281(1):23-40✅Main points:In bony avulsion cases, the focu.. 2024. 3. 17. (Fig 2-E.17) Partial Tears of PCL and Intact MFL https://youtu.be/f5Pix4pMyCshttps://youtu.be/UgiSgNcqguA🔴Partial Tear of PCL1️⃣Frequency and Diagnosis Challenges:Partial tears are more common in the PCL than in the ACL.An acutely torn PCL can appear as a continuous structure in 62% to 75% of cases, making it difficult to differentiate between complete and partial tears.Reference: Magn Reson Imaging Clin N Am. 2022 May;30(2):261-275.2️⃣Imagin.. 2024. 3. 16. (Fig 2-E.16) Bone Contusions In PCL Hyperextension Injury https://youtu.be/EPclnY3G4AYhttps://youtu.be/UgiSgNcqguA📌 PCL Hyperextension Injury📌 1️⃣Hyperextension Injuries: These injuries can lead to contusions of the anterotibial articular surface and the anterior aspect of the femoral condyle. Severe hyperextension injuries may also be associated with a tear of the ACL, PCL, posterior capsule, and injuries to the posterolateral or posteromedial corne.. 2024. 3. 16. (Fig 2-E.14) Common MRI Findings of PCL Tears https://youtu.be/26uy03ZZ9Akhttps://youtu.be/UgiSgNcqguA1️⃣ MRI Findings of Acute PCL Injury✅ Key Indicators:Focal discontinuity of fibers.The anteroposterior diameter of the ligament distal to the genu is greater than 7 mm.Presence of abnormal intermediate or fluid intrasubstance signal, potentially more evident on proton density images.Striated appearance of the PCL.Lax or wavy appearance of t.. 2024. 3. 16. (Fig 2-E.13) Transverse Tear of PCL And Impingement https://youtu.be/Eszla_Ycy6whttps://youtu.be/UgiSgNcqguA🔴 Impingement in the Tibiofemoral Joint (TFJ) 🔴1️⃣ Partial Rupture of PCL and Its Consequences:A partially ruptured Posterior Cruciate Ligament (PCL) led to an impingement in the medial Tibiofemoral Joint (TFJ), necessitating excision.The torn PCL stump, originating from the intercondylar notch, became entrapped in the medial TFJ, causing.. 2024. 3. 16. (Fig 2-E.12) Two Patterns Of The PCL Tears https://youtu.be/-v6nxEn84CYhttps://youtu.be/UgiSgNcqguA1️⃣ MRI Signs of PCL Tear:Focal disruption of the PCL.Amorphous increased signal intensity with disruption of one or both margins of the ligament.Increased signal intensity on proton density images is more common than on T2-weighted images.Nonvisualization of the PCL.Abnormal thickening of the PCL distal to the genu with an anteroposterior .. 2024. 3. 16. (Fig 2-E.11) Femoral Periosteal Avulsion Tear Of The PCL https://youtu.be/YH78klEDz-ohttps://youtu.be/UgiSgNcqguA1️⃣PCL Injuries OverviewMultiligamentous injuries involving the PCL are more common than isolated PCL tears. Midsubstance tears are the most prevalent form. The PCL can be injured through its substance or at its tibial and femoral attachments. (Magn Reson Imaging Clin N Am 22 (2014) 557–580)2️⃣ Surgical ManagementProximal third PCL tears an.. 2024. 3. 16. (Fig 2-E.10) PCL Ganglia and Mucoid degeneration https://youtu.be/hVhFMsTWhGkhttps://youtu.be/UgiSgNcqguA1️⃣PCL GangliaPCL ganglia typically appear as well-defined multilocular cysts adjacent to and along the dorsal PCL surface.Differential diagnosis should be made from a posteromedial meniscal cyst extending centrally within the joint, predominantly posterior to the PCL.Reference: Insights Imaging (2013) 4:257–2722️⃣Mucoid Degeneration and Ga.. 2024. 3. 16. 이전 1 2 3 4 5 다음
