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BACKGROUND: Nowadays, posterior cruciate ligament injury caused by a sports injury or vehicle injury is more common than people think. Posterior cruciate ligament reconstruction is one of the main treatment methods, but there are still a lot of controversies about the surgical method and ligament selection of posterior cruciate ligament reconstruction. OBJECTIVE: To comprehensively analyze the global application trend of posterior cruciate ligament reconstruction and identify promising research hotspots of posterior cruciate ligament reconstruction based on bibliometrics and visual analysis. METHODS: Publications (articles and reviews) related to posterior cruciate ligament reconstruction from 2000 to 2022 were retrieved from the Web of Science (WOS). The country, institution, publication year, author, journal, average citations per item, H index, title, keywords of publication, and the top 25 cited articles were extracted and analyzed in detail. The VOSviewer/citespace/Pajek software was used to analyze the co-occurrence result of keywords to predict the hotspots of posterior cruciate ligament reconstruction. RESULTS AND CONCLUSION: A total of 664 articles were included. (1) In the past 22 years, the number of posterior cruciate ligament reconstruction articles has shown an increasing trend in general. The top 3 countries (the USA, China, and South Korea) accounted for 65.51% of all articles published. The USA has the largest number of publications. The University of Pittsburgh is the largest contributor. Knee Surgery Sports Traumatol Arthrosc and American Journal of Sports Medicine are the most influential journals. Laprade, Robert F. is the professor who has published the most articles in the field of posterior cruciate ligament reconstruction, and Fanelli, GC is the professor who has the highest total chain strength in the field of posterior cruciate ligament reconstruction. (2) The research direction can be divided into the following five clusters: “posterior cruciate ligament anatomical and biomechanical studies”, “posterior cruciate ligament reconstruction prognosis, outcome, and complications”, “posterior cruciate ligament reconstruction surgical method and tendon selection”, “surgical technique”, and “posterior cruciate ligament tear combined with multiple ligament injury”. (3) It is concluded that in terms of the trend of previous years, an increasing number of articles related to posterior cruciate ligament reconstruction will be published in the future. The USA is a world leader in the field of posterior cruciate ligament reconstruction. China and South Korea presented great potential in this area. Anatomical and biomechanical research of posterior cruciate ligament and posterior cruciate ligament reconstruction methods and the selection of tendons may be the future hotspots in the field of posterior cruciate ligament reconstruction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that posterior cruciate ligament injuries are associated with the anatomical morphology of the knee joint. OBJECTIVE: To explore anatomical morphological risk factors for posterior cruciate ligament injury. METHODS: The imaging data of 142 patients who visited Affiliated Hospital of Binzhou Medical University for knee joint problems from January 2015 to August 2022 were retrospectively analyzed. They were divided into posterior cruciate ligament injury group (n=71, including 49 males and 22 females) and posterior cruciate ligament intact group (n=71, including 49 males and 22 females). Intercondylar notch width, intercondylar notch height, bicondyle width, notch width index, angle of intercondylar notch, Blumensaat’s line inlication angle, medial tibial spine height, lateral tibial spine height, tibial spine width, tibiofemoral consistency index, tibial plateau anterior-posterior diameter, medial tibial depth and patellar tendon-tibial shaft angle were measured on MRI images. Posterior tibial slope was measured on X-ray images. The above indicators were included in the logistic regression analysis for investigation. RESULTS AND CONCLUSION: (1) Univariate logistic regression analysis in men showed that tibial spine width, tibiofemoral consistency index, medial tibial depth, and posterior tibial slope were associated with posterior cruciate ligament injury (P < 0.05). Multivariate binary logistic regression analysis showed that tibiofemoral consistency index and medial tibial depth were associated with posterior cruciate ligament damage (P < 0.05). (2) Univariate logistic regression analysis in women showed that medial tibial spine height, lateral tibial spine height, tibial spine width, and posterior tibial slope were associated with posterior cruciate ligament injury (P < 0.05). Multivariate binary logistic regression analysis showed that posterior tibial slope was associated with posterior cruciate ligament damage (P < 0.05). (3) The receiver operating characteristic curve showed that tibiofemoral consistency index, medial tibial depth and posterior tibial slope had a certain predictive value on posterior cruciate ligament damage. (4) These findings suggest that anatomical morphological risk factors for posterior cruciate ligament injury differ between men and women, and tibial spine width and posterior tibial slope are common risk factors. In the male population, abnormal tibial spine width, tibiofemoral consistency index, medial tibial depth, and posterior tibial slope are easy to induce posterior cruciate ligament injury. In the female population, abnormal medial tibial spine height, lateral tibial spine height, tibial spine width, and posterior tibial slope are easy to induce posterior cruciate ligament injury. Clinicians can use the above risk factors to identify abnormal knee morphology, assess people at risk of posterior cruciate ligament injury, and provide preventive advice and guidance for treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patellar dislocation is more common in young female patients, and it is a common cause of adolescent knee pain. For the treatment of patellar dislocation, clinical treatment is divided into surgical treatment and conservative treatment. Surgical treatment generally chooses the medial patellofemoral ligament revascularization. Postoperative recurrence of dislocation may be due to failure to correct risk factors, which requires combined osteotomy and orthopedic treatment. In this way, the anatomical structure of the bone can be changed and the skeletal deformity can be corrected. However, it is still controversial in clinic whether patients need to undergo tibial nodule osteotomy and orthopedic surgery before surgery. OBJECTIVE: A new evaluation index affecting the stability of patellofemoral joint is introduced. Tibial nodule torsion angle: The correlation between tibial nodule torsion angle and patellar dislocation was measured and analyzed. The diagnostic and clinical practical values of tibial nodule torsion angle for patellar dislocation were studied, and the correlation of tibial nodule torsion angle with tibial tubercle-trochlear groove distance and patellar inclination angle was evaluated. METHODS: A total of 42 patients with bone dislocation were collected from the Department of Sports Trauma and Arthroscopic Surgery of First Affiliated Hospital of Anhui Medical University from January to August 2020, and 46 patients with cruciate ligament injury or meniscus injury were considered as the control group. Tibial nodule torsion angle, tibial tubercle-trochlear groove distance and patellar inclination angle of the two groups were measured under CT. The three parameters of the data of the two groups were statistically analyzed. The correlation between tibial nodule torsion angle and patellar dislocation was analyzed and the clinical application value of tibial nodule torsion angle was evaluated. RESULTS AND CONCLUSION: (1) Tibial nodule torsion angle was statistically different between the two groups (P < 0.05). (2) Compared with the other two parameters, tibial nodule torsion angle could be used as a risk factor for patellar dislocation, and had a certain diagnostic ability for patellar dislocation (area under curve=0.923). (3) It is indicated that tibial tubercle torsion angle is closely related to patellar dislocation, and has a certain diagnostic ability for patellar dislocation. Tibial tubercle torsion angle compared with the other two parameters can be incorporated into the factors affecting the stability of patellofemoral joint and can be used in preoperative evaluation to provide a reference for the selection of surgical procedure for patellar dislocation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Arthroscopic reconstruction of posterior cruciate ligament has become the main treatment for severe injury of posterior cruciate ligament. Mastering the characteristics of all kinds of posterior cruciate ligament reconstruction grafts and selecting suitable transplantation materials are considered to be an important link affecting the effect of posterior cruciate ligament reconstruction. OBJECTIVE: To summarize the advantages and disadvantages of autografts, allografts and artificial ligaments in posterior cruciate ligament reconstruction, and put forward improvement strategies and prospect. METHODS: The first author searched the articles about implant materials (autografts, allografts and artificial ligaments) for the reconstruction of posterior cruciate ligament on PubMed database, CNKI database and Wanfang database from 2000 to 2020. The articles obtained in accordance with the search words were screened and retained, and the relevant articles related to the analysis of the advantages and disadvantages of all kinds of posterior cruciate ligament grafts were further analyzed and summarized in detail. RESULTS AND CONCLUSION: Posterior cruciate ligament reconstruction grafts have their own advantages and disadvantages. At present, autogenous hamstring tendon grafts are most widely used in clinic. Ligament enhancement device, internal tension reduction technique or tendon surface coating technology can improve the effect of posterior cruciate ligament reconstruction. Autogenous tendons, allogeneic tendons and artificial ligaments are all important sources of posterior cruciate ligament reconstruction grafts in the short term. With the progress of artificial ligament and tissue engineering ligament research in the long term, it is expected to completely solve the problem of posterior cruciate ligament reconstruction materials. When selecting posterior cruciate ligament grafts, surgeon should consider the level of activity expected by patients, the types of activities they participate in, their professional characteristics, the reconstruction techniques and habits mastered by doctors, and the fixed materials matched with the grafts, so as to select a suitable posterior cruciate ligament reconstruction graft. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the increasing cases of posterior cruciate ligament injury, there are endless protocols for diagnosing and treating posterior cruciate ligament injury. However, there are few reviews of the integrity of posterior cruciate ligament. OBJECTIVE: To complete a comprehensive review of posterior cruciate ligament injury in terms of anatomy, clinical manifestations, auxiliary examination, treatment methods and rehabilitation strategies. METHODS: The PubMed, Ovid, CKNI, and WanFang databases were retrieved using the key words of “posterior cruciate ligament, PCL, anatom*, diagnos*, treatments, surger*, rehabilitation.” A total of 223 articles were searched. After removal of repetitive and ineligible literature, 65 articles were included for review. RESULTS AND CONCLUSION: Missed diagnosis and misdiagnosis of posterior cruciate ligament injury certainly exist. Posterior cruciate ligament injuries are mostly caused by traffic injuries and sports injuries, and are accompanied by other structural injuries to a certain degree. A full understanding of patient’s medical history, accurate physical examination methods, and sophisticated auxiliary examinations can help to correctly identify injuries to the posterior cruciate ligament and the surrounding structures, so as to formulate a reasonable diagnosis and treatment protocol. Research suggests that patients with posterior cruciate ligament injury should be subjected to reconstruction of the posterior cruciate ligament as soon as possible to reduce the risk of further degeneration. At present, there are still large disagreements on the diagnosis, treatment methods, and rehabilitation strategies of posterior cruciate ligament injury. So, a large number of rigorous randomized controlled trials are urgently needed to select the most suitable diagnosis and treatment methods. [ABSTRACT FROM AUTHOR]

BACKGROUND: Injury of the posterolateral complex of the knee joint is a common type of multiple ligament injuries of the knee joint. The reconstruction of the posterolateral complex can restore the posterior and lateral stability of the knee joint and rebuild the stability of the knee joint. OBJECTIVE: To discuss the feasibility and clinical effect of modified LaPrade method for functional reconstruction of posterolateral complex of knee with autograft peroneus longus tendon. METHODS: Fourteen patients with posterolateral complex and posterior cruciate ligament injuries who were treated in the Department of Orthopedics, Affiliated Hospital of Zunyi Medical University from October 2014 to March 2017 were enrolled in this study. Posterior cruciate ligament and posterolateral complex were simultaneously constructed in stage one. The injury of the posterolateral complex of the knee joint was Fanelli type C. Modified LaPrade method was used to functional reconstruction of posterolateral complex of knee with peroneus longus tendon. The anatomy and function of the core ligament of the posterolateral complex was simulated. Follow-up time was beyond 1 year. The tibia posterior displacement on stress radiographs, lateral compartment gapping on varus stress radiographs at 0° knee extension, and external rotation angle of tibia at 30° knee flexion were compared before and after surgery. The joint function was evaluated according to the score of International Knee Documentation Committee and Lysholm Knee score. RESULTS AND CONCLUSION: (1) All patients were followed up for 12-18 months. All patients had no knee-length restriction, with flexion limitation in some patients. (2) At the last follow-up, the tibia posterior displacement on stress radiographs, lateral compartment gapping on varus stress radiographs and external rotation angle of tibia at 30° knee flexion were reduced from preoperation, with statistically significant differences (P=0.000). (3) The International Knee Documentation Committee function was corrected from D preoperatively to A in 8 cases and B in 6 cases postoperatively. The average Lysholm score was increased from (32.4±5.6) preoperatively to (82.7±6.4) postoperatively, and the differences were statistically significant (P=0.000). (4) It is indicated that with peroneus longus tendon, the anatomy and function of the core ligament of the posterolateral complex were simulated by modified LaPrade method to functional reconstruction of posterolateral complex of knee, and the postoperative knee function recovered well. [ABSTRACT FROM AUTHOR]

BACKGROUND: Side-step cutting is the most common offensive technique in the field of sports that greatly increases the risk of knee injury. However, the biomechanical performance strategies and the characteristics of lower limb joint load during the side-step cutting are not very clear. OBJECTIVE: To carry out the biomechanics test of the side-step cutting in lower limb movement strategy among college female basketball and football players, and to analyze the kinematics and dynamics parameters of the lower limbs, providing an important reference for athletes and trainers to prevent lower limb injuries, especially cruciate ligament injury. METHODS: Twelve female football and basketball players coming from a university were selected as the experimental subjects. The kinematics and dynamics parameters of the side-step cutting were acquired synchronously by using the three-dimensional dynamometer and the motion image shooting system. The relevant data were processed and analyzed by SPSS 21.0 software. The study protocol was approved by Tianjin University of Sports in China. RESULTS AND CONCLUSION: (1) Football players had greater ankle metatarsal flexion angle and hip abduction angle, maximum ankle valgus angle, knee flexion and rotation angle with knee flexion and rotation angle changes. {2) Football players had greater peak ankle rotation and hip adduction moment, while basketball players had larger plantar flexion moment. (3} Basketball players have smaller first and second peak values of forward and backward partial braking force, the first peak value of vertical partial braking force and larger peak value of forward and backward partial pushing force. In the process of side-step cutting, football players are accustomed to stop in a sudden way with their forefeet touching, thus producing higher ground reaction force and increasing knee flexion angle to buffer, while having greater ankle valgus angle and knee rotation angle. Basketball players have smaller knee flexion angle in the process of side-step cutting. A smaller angle is not conducive to the lower limb joint to buffer the ground reaction force, and then increases the risk of anterior cruciate ligament injury. [ABSTRACT FROM AUTHOR]

BACKGROUND: Imbalance between subchondral bone resorption and bone fonnation occurs in osteoarthritis. Our preliminary study has found that the subchondral bone changes precede the articular cartilage changes in knee osteoarthritis rats. OBJECTIVE: To observe the changes of subchondral bone in knee osteoarthritis rats, and to explore the effect of elcatonin on the expression of p38 MAPK and absorption of subchondral bone. METHODS: Female Sprague-Dawley rats, 3 months of age, were randomly divided into three groups: sham operation group (n=6, the adipose tissue of the same size as the ovary was removed without ovariectomy, the bilateral knee joints were opened, but without cruciate ligament injury); model group (n=6, bilateral ovariectomy plus bilateral cruciate ligament injury, no treatment); elcatonin group (n=6, ovariectomy plus cruciate ligament injury, intramuscular injection of 5lU/kg elcatonin, twice weekly). The bone mineral density and p38 protein expression levels in subchondral bone were detected at 12 weeks. The serum levels of C-terminal crosslinking telopeptides of type I collagen, C-terminal crosslinking telopeptides of type II collagen, interleukin-1, interleukin-6 and bone-specific alkaline phosphatase, tartrate resistant acid phosphatase 5b were detected. RESULTS AND CONCLUSION: (1) The bone volume fraction and trabecular bone number in the elcatonin group were significantly higher than those in the model group (P < 0.05), and the trabecular separation in the elcatonin group was lower than that in the model group (P < 0.05). (2) The bone volume fraction, trabecular bone number and trabecular thickness in the model group were lower than those in the sham operation group (P < 0.01 or P < 0.05), and the trabecular separation was higher than that in the sham operation group (P < 0.01). (3) The serum levels of C-tenninal crosslinking telopeptides of type I collagen, C-tenninal crosslinking telopeptides of type II collagen, interleukin-1, interleukin-6 and tartrate resistant acid phosphatase 5b in the elcatonin group was significanUy lower than those the model group (P < 0.05). and the above levels in the model group were significantly higher than those in the sham operation group (P < 0.05). (4) The p38 expression level in subchondral bone in the elcatonin group was significantly lower than that in the model group (P < 0.01 ), and the level in the model group was significantly higher than that in the sham operation group (P < 0.01). (5) These results indicate that elcatonin may inhibit the secretion of osteoarthritis pro-inflammatory factors and subchondral bone resorption by down-regulating the expression level of p38 MAPK. [ABSTRACT FROM AUTHOR]