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Posterior cruciate ligament femoral insertion site characteristics. Importance for reconstructive procedures
Etienne A Mejia1, Frank R Noyes, Edward S Grood
1Cincinnati Sportsmedicine and Orthopaedic Center and the Noyes Biomechanics Laboratories, Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio 45219, USA.
Background:
Previous descriptions of the insertion site of the posterior cruciate ligament are inadequate.
Hypothesis:
More than one reference system is required to adequately represent the anatomy of the femoral attachment.
Study Design:
Descriptive anatomic study.
Methods:
Twelve cadaveric specimens were evaluated by using two measurement methods relative to the femoral articular cartilage margin and two methods relative to the intercondylar femoral roof.
Results:
Reference lines perpendicular to the articular cartilage best defined the 12- and 1-o'clock positions, and those perpendicular to the articular cartilage or parallel to the femoral shaft best defined the 2-, 3-, and 4-o'clock positions. The angle of the proximal attachment to the roof was 88 degrees +/- 5.5 degrees. The posterior cruciate ligament was a continuum of fibers rather than two distinct bundles, and its attachment showed variability in shape and thickness, extending past the midline in the notch (11:21 +/- 15 minutes to 4:12 +/- 20 minutes, right knee).
Conclusions:
More than one measurement system is required to accurately describe the femoral origin of the posterior cruciate ligament.
Clinical Relevance:
Accurate assessment of the anatomy is crucial for successful surgical reconstruction of the posterior cruciate ligament femoral attachment.