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In vivo posterior cruciate ligament elongation in running activity after anatomic and non-anatomic anterior cruciate ligament reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The goals of this study were to (1) investigate the in vivo elongation behaviour of the posterior cruciate ligament (PCL) during running in the uninjured knee and (2) evaluate changes in PCL elongation during running after anatomic or non-anatomic anterior cruciate ligament (ACL) reconstruction.

Methods

Seventeen unilateral ACL-injured subjects were recruited after undergoing anatomic (n = 9) or non-anatomic (n = 8) ACL reconstruction. Bilateral high-resolution CT scans were obtained to produce 3D models. Anterolateral (AL) and posteromedial (PM) bundles insertion sites of the PCL were identified on the 3D CT scan reconstructions. Dynamic knee function was assessed during running using a dynamic stereo X-ray (DSX) system. The lengths of the AL and PM bundles were estimated from late swing through mid-stance. The contralateral knees served as normal controls.

Results

Control knees demonstrated a slight decrease in AL bundle and a significant decrease in PM bundle length following foot strike. Length and elongation patterns of the both bundles of the PCL in the anatomic ACL reconstruction group were similar to the controls. However, the change in dynamic PCL length was significantly greater in the non-anatomic group than in the anatomic reconstruction group after foot strike (p < 0.05).

Conclusion

The AL bundle length decreased slightly, and the PM bundle length significantly decreased after foot strike during running in uninjured knees. Anatomic ACL reconstruction maintained normal PCL elongation patterns more effectively than non-anatomic ACL reconstruction during high-demand, functional loading. These results support the use of anatomic ACL reconstruction to achieve normal knee function in high-demand activities.

Level of evidence

Case–control study, Level III.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Beijing Jishuitan Hospital, 31 Xinjiekou Dongjie St., Beijing, 100035, China

    Jing Tang

  2. Department of Mechanical Engineering, University of Washington, Seattle, WA, USA

    Eric Thorhauer

  3. Orthopedic Research Laboratories, University of Pittsburgh, 3820 South Water St., Pittsburgh, PA, 15203, USA

    Karl Bowman, Freddie H. Fu & Scott Tashman

Authors
  1. Jing Tang
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  2. Eric Thorhauer
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  3. Karl Bowman
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  4. Freddie H. Fu
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  5. Scott Tashman
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Corresponding author

Correspondence to Scott Tashman.

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The authors declare that they have no conflict of interest.

Additional information

The work was performed at the Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC), USA.

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Tang, J., Thorhauer, E., Bowman, K. et al. In vivo posterior cruciate ligament elongation in running activity after anatomic and non-anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 25, 1177–1183 (2017). https://doi.org/10.1007/s00167-016-4180-4

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  • DOI: https://doi.org/10.1007/s00167-016-4180-4

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