Abstract
Congenital absence of the cruciate ligaments is a very rare condition, with most reported cases being related to the anterior cruciate ligament (ACL). Posterior cruciate ligament (PCL) congenital abnormalities have been described as almost always being associated with other anomalies. We present a case of a patient with lateral knee pain and subjective instability sensation after a low-energy trauma secondary to a lateral meniscus tear, with absence of the PCL on MRI examination and thickened meniscofemoral ligaments, with anterior and superior insertion at the femur, in the footprint of PCL. The patient had a menisci repair, without PCL reconstruction. At the 6-month follow-up, the patient did not report any instability symptoms during his daily work and sports activities. There are therapeutic implications in distinguishing a chronic PCL tear from an aplasia, so it is important to detect some signs in imaging that may guide to differentiate them, as there could be differences in the course and thickness of meniscofemoral ligaments, besides the absence of the entire PCL. To our knowledge, this is the first case of PCL agenesis with arthroscopic correlation.
Similar content being viewed by others
References
Kaelin A, Hulin PH, Carlioz H. Congenital aplasia of the cruciate ligaments. A report of six cases. J Bone Joint Surg Br. 1986;68:827–8.
Tolo VT. Congenital absence of the menisci and cruciate ligaments of the knee. J Bone Joint Surg Am. 1981;63:1022–4.
Manner HM, Radler C, Ganger R, Grill F. Dysplasia of the cruciate ligaments: radiographic assessment and classification. J Bone Joint Surg Am. 2006;88:130–7.
Barrett GR, Tomasin JD. Bilateral absence of the anterior cruciate ligament. Orthopedics. 1998;11:431–4.
De Ponti A, Sansone V, da Gama Malchér M. Bilateral absence of the anterior cruciate ligament. Arthroscopy. 2001;17:E26.
Kaelin A, Hulin PH, Carlioz H. Congenital aplasia of the cruciate ligaments. J Bone Joint Surg Br. 1986;68:827–8.
Thomas NP, Jackson AM, Aichroth PM. Congenital absence of the anterior cruciate ligament. J Bone Joint Surg Br. 1985;67:572–5.
Malumed J, Hudanich R, Collins M. Congenital absence of the anterior and posterior cruciate ligaments in the presence of bilateral absent patellae. Am J Knee Surg. 1999;12:241–3.
Theodorou DJ, Theodorou SJ, Pagounis J, Mantzoukis F, Vardakas D. Isolated congenital aplasia of the posterior cruciate ligament. Eurorad Radiology Case Database. 2013, Mar 20 (Online) www.eurorad.org/case.php?id=10836
da Gama Malchér M, Bruno A, Grisone B, Bernardelli G, Pietrogrande L. Isolated congenital absence of posterior cruciate ligament? A case report. Chir Organi Mov. 2008;92(2):105–7.
Benassi AB, Guerreiro JPF, Queiroz AO, Gasparelli RG, Danieli MV. Anterior and posterior cruciate ligament agenesis. J Surg Case Rep. 2018;2018(8):rjy216.
Gupte CM, Bull AMJ, Thomas RD, Amis A. The meniscofemoral ligaments: secondary restraint to the posterior drawer. J Bone Joint Surg Br. 2003;85B:765–73.
Shybut T, Vega C, Haddad J, et al. Effect of lateral meniscal root tear on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 2015;43(4):905–11.
Berruto M, Gala L, Usellini E, Duci D, Marelli B. Congenital absence of the cruciate ligaments. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1622–5.
Gardner E, O’Rahilly R. The early development of the knee joint in staged human embryos. J Anat. 1968;102:289–99.
Johansson E, Aparisi T. Congenital absence of cruciate ligaments. Clin Orthop Relat Res. 1982;162:108–11.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
García, N., Debandi, A., Delgado, G. et al. Isolated posterior cruciate ligament aplasia: a case report. Skeletal Radiol 48, 1439–1442 (2019). https://doi.org/10.1007/s00256-019-3161-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-019-3161-3