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The Intact Posterior Cruciate Ligament Not Only Controls Posterior Displacement but Also Maintains the Flexion Gap

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The PCL is a strong stabilizer of the knee and provides posterior stability to the tibia. However, sagittal alignment of the PCL with the knee at 90° flexion suggests the PCL might play a role not only in posterior stabilization but also in maintaining the flexion gap.

Questions/purposes

We determined whether the intact PCL helps maintain the flexion gap.

Methods

We examined axial radiographs and gravity sag views of 17 patients with chronic isolated unilateral PCL injury. The flexion gap was defined as the mean value of the medial and lateral distances between the femoral and tibial bones on the axial radiograph. Increase in the flexion gap and posterior laxity were determined by comparing the patients’ injured and contralateral uninjured knees.

Results

The flexion gap of PCL injured knees (median, 7.5 mm; range, 5.3–11.5 mm; medial median, 6.2 mm; medial range, 3.7–8.3 mm; lateral median, 7.9 mm; lateral range, 5.3–11.5 mm) was larger than that seen in uninjured knees (median, 5.0 mm; range, 4.0–7.6 mm; medial median, 4.6 mm; medial range 3.4–7.1 mm; lateral median, 5.6; lateral range, 4.5–11.2 mm). The increment in the medial distance was similar to that in the lateral distance. Posterior laxity of injured knees was 9.1 (median); 5.4 to 15.2 (range) mm greater than that of uninjured knees. We found no correlation between posterior laxity and the flexion gap increment.

Conclusions

Our data suggest the intact PCL controls posterior displacement and maintains the flexion gap.

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Acknowledgments

We thank Y. Tanaka PhD, MD, and Y. Yonetani PhD, MD, for gathering data and helping to diagnose chronic isolated PCL injuries.

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Authors and Affiliations

  1. Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima-ku, Osaka City, Osaka, 534-0021, Japan

    Yoshio Matsui PhD, MD

  2. Hannwa Arthroplasty Center, Sakai City, Osaka, Japan

    Yoshinori Kadoya PhD, MD

  3. Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Habikino City, Osaka, Japan

    Shuji Horibe PhD, MD

Authors
  1. Yoshio Matsui PhD, MD
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  2. Yoshinori Kadoya PhD, MD
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  3. Shuji Horibe PhD, MD
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Corresponding author

Correspondence to Yoshio Matsui PhD, MD.

Additional information

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This study was performed at Osaka Rosai Hospital, Sakai City, Osaka, Japan.

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Matsui, Y., Kadoya, Y. & Horibe, S. The Intact Posterior Cruciate Ligament Not Only Controls Posterior Displacement but Also Maintains the Flexion Gap. Clin Orthop Relat Res 471, 1299–1304 (2013). https://doi.org/10.1007/s11999-012-2707-7

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  • DOI: https://doi.org/10.1007/s11999-012-2707-7

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