Pes Anserinus Research Articles

Pes anserinus transfer for antero-medial instability of the knee

AbstractThirty patients are assessed who underwent pes anserinus transfer for antero-medial instability of the knee. Twenty one of these returned to a normal seagoing category after a mean period of 5 months 1 week. The value of pes anserinus transfer in the treatment of antero-medial instability is discussed.

Pes anserinus transfer for the unstable knee: A 7-year follow-up of 43 cases of ruptured anterior cruciate ligament

On average 7 years postoperatively, we evaluated 43 consecutive patients who had had pesoplasty for chronic injury of the anterior cruciate ligament. Fourteen patients had undergone further surgery during the follow-up period; ten of these had extra- or intra-articular stabilizing procedures, and eight meniscectomies were performed after the index operation. At follow-up of the 33 knees that had not had additional stabilizing surgery, only one-third of the knees had normal radiograms, and the majority had anterolateral rotational instability (pivot shift) which, however, did not exclude satisfactory knee function. We conclude that improvement after transfer of the pes anserinus tendons was due to the simultaneous meniscectomy; we do not believe that the pesoplasty changed the natural course of the chronic rupture of the anterior cruciate ligament.

Preliminary report on the Jones, Ellison, Slocum (JES) repair for symptomatic anterior cruciate deficient knees.

A modified Jones intraarticular anterior cruciate reconstruction was combined with a distal iliotibial band transfer (Ellison) and a pes anserinus transfer (Slocum) for patients with symptomatic anterior cruciate deficient knees. The procedure was performed on 15 young (average age, 22.5 years) athletes, in a single operation through a long, straight, anterior, midline incision. Preoperatively, all 15 patients (15 knees) had symptomatic instability and all but one had a positive pivot shift. At follow up (averaging 39 month range 24-60 months) 13 (93%) had the pivot shift eliminated and only one, with 36 months followup, had instability on return to sports. Postoperatively, patients were immobilized 3 weeks and then were started on a physical therapy program which ended in return to sports at 1 year.

Posterior problems in the knee. Posterior cruciate insufficiency and posterolateral rotatory insufficiency.

During a recent three-year period, 39 patients underwent surgical procedures for lesions of the posterior complex of the knee. The results in 28 followed for greater than six months (average followup, 16 months) are reported; eight are presently in the early rehabilitative phase and three have been lost to followup. In reconstruction for chronic laxity, a semitendinosus replacement of the posterior cruciate ligament with anterior advancement of the lateral arcuate complex is recommended. Use of the medial gastrocnemius tendon is still advised in selected cases. Reconstruction for posterolateral rotatory laxity with an intact posterior cruciate is performed with anterior advancement of the popliteus tendon and the arcuate complex. Pes anserinus transfer, imbrication of the posterior oblique ligament, and biceps tenodesis may be performed as supplemental procedures.

Rotational Strength and Flexibility of the Knee following Pes Anserinus Transplant Surgery

Abstract The purpose of this study was to determine the effects of the pes anserinus transplant (PAT) on the amount and strength of tibial rotation on the femur. Six male and two female rehabilitated subjects were used in the investigation. Each subject was secured to a specially constructed testing platform which positioned the hips and knees at 90° of flexion. Both lower limbs were tested for inward and outward tibial rotation on the femur using the Leighton flexometer and strength of inward and outward tibial rotation on the femur using the cable tensiometer. The results indicated that with the knee at 90° of flexion there was no significant difference in degrees of rotation or rotational strength between the surgical and nonsurgical limbs in rehabilitated subjects following pes anserinus transplant surgery.

Modified Eriksson procedure for chronic anterior cruciate instability.

The results of ten knee reconstructions done for chronic anterior cruciate instability were analyzed. Reconstruction was done by utilizing the medial one third of the patellar tendon as an intraarticular substitute for the anterior cruciate ligament. In addition, dynamic back-up was provided by the pes anserinus and biceps tendons. No patient regained normal stability, but early results showed both clinical and functional improvement. It is suggested that one should consider primary reconstruction of the anterior cruciate utilizing this technique if acute primary repair cannot be accomplished.

Das instabile Kniegelenk — aktuelle Gesichtspunkte in Grundlagenforschung, Diagnostik und Therapie

The increase of knee lesions within the last years has provoked a generally more intensive discussion about the functional anatomy, the biomechanics and the pathophysiology of the capsule and ligaments of the knee joint. Several authors have stressed the importance of the active and passive factors, stabilizing the knee joint. The injury to a single element leads to different instabilities, as proven by meticulous clinical and radiological diagnostic procedures. The progress in the treatment of fresh and old injuries of knee ligaments is connected with the names of O'Domoghue, Slocum, Larson, Hughston, Nicholas and Trillat. For a fresh completely ruptured ligament surgery is recommended. Torn menisci are reattached whenever possible. An initial graft can be necessary for ruptures of the anterior cruciate ligament. Complex injuries, which are found most frequently, have to be dealt with completely. Old injuries of capsule and ligaments may require a plastic reconstruction. For the reconstruction of the anterior cruciate ligament it has been proven useful to take distally attached tendons of the pes anserinus group as well as the free graft from the central 1/3 of the patellar ligament. Rotational instabilities have to be dealt with according to the type of instability. The techniques of Slocum and Larson and the "five in one" reconstruction by Nicholas have to be emphasized as treatment of the anteromedial rotational instabilities. McIntosh has shown a procedure which seems to be successful for anterolateral rotational instabilities. Several techniques have been compared with our own experiences and late results studied. The point is stressed that further progress has to be made for the treatment of injuries to ligaments of the knee.

Pes anserinus transplant: impressions after a decade of experience.

"This paper presents the impressions gained from the time of our first surgical case of pes anserinus transplant over a decade ago ( 1962) to the present. It is intended to in form the reader of the evolution of this pro cedure, its use and misuse, and the errors in indication and technique which we have encountered in our practice." The Authors