posterior cruciate ligament tear
Knöcherner
Ausriss des hinteren Kreuzbandes in der Computertomographie im Knochen- und Weichteilfenster.
Posterior cruciate ligament (PCL) tears are less common than anterior cruciate ligament tears.
Epidemiology
Posterior cruciate ligament tears account for ~10% (range 2-23%) of all knee injuries .
Clinical presentation
Sports injuries and car accidents (dashboard injury) are equally responsible for these injuries . Many patients will be asymptomatic and their clinical examination is unremarkable. However, some patients may have knee instability or posterior sag sign.
Pathology
Three mechanisms of injury have been proposed :
- posterior tibial displacement in a flexed knee
- hyperextension
- rotation with an abduction or adduction force
Associations
PCL injuries are isolated in only 30% of cases and are thus commonly associated with other injuries :
- ligamentous injury (~40%)
- meniscal tears
- posterolateral corner injury
- bone contusion (80%) or avulsion fracture (<10%)
- knee joint effusion
Radiographic features
MRI
Features of posterior ligament tears include :
- PCL usually remains contiguous (~70%) although there may be complete or partial ligamentous disruption
- absent PCL replaced by high T1 and T2 signal
- enlarged and swollen PCL: >7 mm AP diameter of the vertical portion on sagittal imaging is indicative of a tear
Treatment and prognosis
PCL tears may result in chronic instability and early degenerative change .
Differential diagnosis
- mucoid degeneration
- meniscofemoral ligaments can mimic a PCL tear
Siehe auch:
- Ligamentum meniscofemorale posterius
- Avulsionsfrakturen am Knie
- posterior cruciate ligament avulsion fracture
- Verletzungen hinteres Kreuzband
- Ruptur des vorderen Kreuzbandes
und weiter:
Assoziationen und Differentialdiagnosen zu hintere Kreuzbandruptur:
