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Posterior instability of the knee joint. An experimental study
Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
|January 1, 1986
Summary
The posterior cruciate ligament (PCL) and surrounding knee structures are crucial for stability. Transecting these, especially the popliteal tendon, significantly increases tibial displacement and rotation during flexion.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Knee Ligament Research
Background:
- The posterior cruciate ligament (PCL) is a primary stabilizer of the knee.
- Understanding the role of secondary stabilizers is essential for managing knee instability.
Purpose of the Study:
- To investigate the contribution of the PCL and surrounding knee structures to rotational and translational knee instability.
- To quantify the impact of isolated and combined ligamentous lesions on knee joint stability.
Main Methods:
- Utilized 25 cadaveric knee specimens for biomechanical testing.
- Assessed tibial displacement and rotation from 0 to 90 degrees of flexion under constant load.
- Performed sequential transection of the PCL, medial, and lateral knee structures, including the popliteal tendon.
Main Results:
- Isolated PCL transection significantly increased posterior tibial displacement.
- Combined PCL and lateral structure lesions, particularly involving the popliteal tendon, doubled posterior tibial displacement.
- Significant tibial rotation occurred only after combined medial or lateral structure lesions.
- A reverse pivot shift and anteromedial subluxation were observed following specific combined lesions.
Conclusions:
- The PCL is vital for controlling posterior tibial translation.
- The popliteal tendon and other lateral structures play a significant secondary stabilizing role.
- Combined injuries to collateral ligaments and the PCL lead to substantial rotatory instability.