Advertisement

Anatomy – Biomechanics – Novel Imaging of the Native PCL

  • Tom Van Hoof
  • Michiel Cromheecke
  • Thomas Tampere
  • Katharina D’herde
  • Jan Victor
  • Peter C. M. Verdonk
  • Jacques Menetrey
  • Sven Scheffler
  • Patrick Djian
  • Konstantinos G. Makridis
  • Fabrizio Margheritini
Chapter

Abstract

The PCL is considered an intra-articular and extra-synovial structure and its dimensions have been well described. Its length is 32–38 mm with a cross-sectional area of 11 mm2, and the bony insertion sites are three times larger than its mid-substance [11]. The average area of the femoral footprint of the anterolateral (AL) bundle is 118 ± 23.95 and of the posteromedial (PM) bundle is 90 ± 16.13 [23]. The distance from the medial articular cartilage has been found at 13 mm posteriorly and inferiorly [33]. The average area of the tibial footprint of the AL bundle is 93.1 ± 16.6 and of the PM bundle is 150.8 ± 31 [48]. The distance from the medial articular cartilage has been found at 8 mm posteriorly and 20 mm inferiorly. Both bundles insert as a unique tendon on the posterior aspect of the tibia approximately 1–1.5 cm distal to the joint line and their centre is located, medial to lateral, 48 % of the width of the tibial plateau [8].

Keywords

Posterior Cruciate Ligament Posterior Cruciate Ligament Reconstruction Posterolateral Corner Posterior Cruciate Ligament Injury Posterior Tibial Translation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    De Maeseneer M, Jager T, Vanderdood K, Van Roy P, Shahabpour M, Marcelis S (2003) Ultrasound during dissection of cadaveric specimens: a new method for obtaining ultrasound-anatomic correlations in musculoskeletal radiology. Eur Radiol 14:870–874CrossRefGoogle Scholar
  2. 2.
    Godfrey JD (1973) Ligamentous injuries of the knee. Curr Pract Orthop Surg 5:56–92Google Scholar
  3. 3.
    Van Hoof T, Gomes GT, Audenaert E, Verstraete K, Kerckaert I, D’Herde K (2008) 3D computerized model for measuring strain and displacement of the brachial plexus following placement of reverse shoulder prosthesis. Anat Rec (Hoboken) 291:1173–1185CrossRefGoogle Scholar
  4. 4.
    Baker CL Jr, Norwood LA, Hughston JC (1984) Acute combined posterior cruciate and posterolateral instability of the knee. Am J Sports Med 12:204–208PubMedCrossRefGoogle Scholar
  5. 5.
    Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15:553–557PubMedCrossRefGoogle Scholar
  6. 6.
    Grood ES, Stowers SF, Noyes FR (1988) Limits of movement in the human knee: effect of sectioning the posterior cruciate ligament and posterolateral structures. J Bone Joint Surg 70A:88–97Google Scholar
  7. 7.
    Forsythe B, Harner C, Martins CA, Shen W, Lopes OV Jr, Fu FH (2009) Topography of the femoral attachment of the posterior cruciate ligament. Surgical technique. J Bone Joint Surg Am 91(Suppl 2 Pt 1):89–100PubMedGoogle Scholar
  8. 8.
    Groscurth P, Eggli P, Kapfhammer J, Rager G, Hornung JP, Fasel JDH (2001) Gross anatomy in the surgical curriculum in Switzerland: improved cadaver preservation, anatomical models, and course development. Anat Rec (New Anat) 265:254–256CrossRefGoogle Scholar
  9. 9.
    Miller MD, Harner CD, Kashiwaguchi S (1994) Acute posterior cruciate ligament injuries. In: Fu FH, Harner CD, Vince KG (eds) Knee surgery, vol 1. Williams & Wilkins, Baltimore, pp 749–768Google Scholar
  10. 10.
    Noyes FR, Barber-Westin SD (1996) Treatment of complex injuries involving the posterior cruciate and posterolateral ligaments of the knee. Am J Knee Surg 9:200–214PubMedGoogle Scholar
  11. 11.
    Fisher SP, Fox JM, Del Pizzo W et al (1991) Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone and Joint Surg 73A:2–10Google Scholar
  12. 12.
    Clancy WG Jr, Shelbourne KD, Zoellner GB et al (1983) Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament. Report of a new procedure. J Bone Joint Surg 65A:310–322Google Scholar
  13. 13.
    Covey DC, Sapega AA (1993) Injuries to the posterior cruciate ligament. J Bone Joint Surg 75A:1376–1386Google Scholar
  14. 14.
    Harner CD, Hoher J (1998) Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med 26(3):471–82PubMedGoogle Scholar
  15. 15.
    Tajima G, Nozaki M, Iriuchishima T, Ingham SJ, Shen W, Smolinski P, Fu FH (2009) Morphology of the tibial insertion of the posterior cruciate ligament. J Bone Joint Surg Am 91(4):859–66PubMedCrossRefGoogle Scholar
  16. 16.
    Miller M, Bergfeld JA, Fowler PJ, Harner CD, Noyes FR (1999) The posterior cruciate ligament injured knee: principles of evaluation and treatment. AAOS Instr Course Lect 48:199–207Google Scholar
  17. 17.
    Parolie JM, Bergfeld JA (1986) Long-term results of non-operative treatment of isolated posterior cruciate ligament injuries in the athlete. Am J Sports Med 14:35–38PubMedCrossRefGoogle Scholar
  18. 18.
    Shelbourne KD, Davis TJ, Patel DV (1999) The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries: a prospective study. Am J Sports Med 27:276–283PubMedGoogle Scholar
  19. 19.
    Lee YS, Han SH, Jo J, Kwak KS, Nha KW, Kim JH (2011) Comparison of 5 different methods for measuring stress radiographs to improve reproducibility during the evaluation of knee instability. Am J Sports Med 39:1275–1281PubMedCrossRefGoogle Scholar
  20. 20.
    Kam CK, Chee DW, Peh WC (2010) Magnetic resonance imaging of cruciate ligament injuries of the knee. Can Assoc Radiol J 61:80–89PubMedCrossRefGoogle Scholar
  21. 21.
    Schulz MS, Steenlage ES, Russe K, Strobel MJ (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338PubMedCrossRefGoogle Scholar
  22. 22.
    Sidles JA, Clark JM, Garbini JL (1991) A geometric theory of the equilibrium mechanics of fibers in ligaments and tendons. J Biomech 24:943–949PubMedCrossRefGoogle Scholar
  23. 23.
    McAllister DR, Miller MD, Sekiya JK, Wojtys EM (2009) Posterior cruciate ligament biomechanics and options for surgical treatment. Instr Course Lect 58:377–388PubMedGoogle Scholar
  24. 24.
    Logan M, Williams A, Lavelle J et al (2004) The effect of posterior cruciate ligament deficiency on knee kinematics. Am J Sports Med 32:1915–1922PubMedCrossRefGoogle Scholar
  25. 25.
    Roberts CC, Towers JD, Spangehl MJ, Carrino JA, Morrison WB (2007) Advanced MR imaging of the cruciate ligaments. Radiol Clin North Am 45:1003–16PubMedCrossRefGoogle Scholar
  26. 26.
    Cosgarea AJ, Jay PR (2001) Posterior cruciate ligament injuries: evaluation and management. J Am Acad Orthop Surg 9:297–307PubMedGoogle Scholar
  27. 27.
    Noyes F, Barber-Weston S, Grood E (2001) Newer concepts in the treatment of posterior cruciate ligament ruptures. In: Insall JN, Scott WN (eds) Surgery of the knee, 3rd edn. Churchill Livingstone, New York, NY, pp 841–878Google Scholar
  28. 28.
    Muller W (1983) The knee: form, function and ligament reconstruction. Springer, Berlin, pp 246–248Google Scholar
  29. 29.
    Sekiya JK, Whiddon DR, Zehms CT, Miller MD (2008) A clinically relevant assessment of posterior cruciate ligament and posterolateral corner injuries: evaluation of isolated and combined deficiency. J Bone Joint Surg Am 90:1621–1627PubMedCrossRefGoogle Scholar
  30. 30.
    Lutz GE, Palmitier RA, An KN et al (1993) Comparison of tibio-femoral joint forces during open-kinetic-chain and closed-kinetic-chain exercises. J Bone Joint Surg Am 75:732–739PubMedGoogle Scholar
  31. 31.
    Grover JS, Basset LW, Gross ML et al (1990) Posterior cruciate ligament: MR imaging. Radiology 174:527–530PubMedGoogle Scholar
  32. 32.
    Kannus P, Bergfeld J, Jarvinen M et al (1991) Injuries to the posterior cruciate ligament of the knee. Sports Med 12:110–131PubMedCrossRefGoogle Scholar
  33. 33.
    Staubli HU, Jakob RP (1990) Posterior instability of the knee near extension. A clinical and stress radiographic analysis of acute injuries of the posterior cruciate ligament. J Bone Joint Surg Br 72:225–230PubMedGoogle Scholar
  34. 34.
    Noyes FR, Stowers SF, Grood ES et al (1993) Posterior subluxations of the medial and lateral tibiofemoral compartments. An in vitro ligament sectioning study in cadaveric knees. Am J Sports Med 21:407–414PubMedCrossRefGoogle Scholar
  35. 35.
    Irizarry JM, Recht MP (1997) MR imaging of the knee ligaments and the postoperative knee. Radiol Clin North Am 35:45–76PubMedGoogle Scholar
  36. 36.
    Lopez-Vidriero E, Simon DA, Johnson DH (2010) Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications. Sports Med Arthrosc 18:230–237PubMedCrossRefGoogle Scholar
  37. 37.
    Allen CR, Kaplan LD, Fluhme DJ, Harner CD (2002) Posterior cruciate ligament injuries. Curr Opin Rheumatol 14:142–149PubMedCrossRefGoogle Scholar
  38. 38.
    Senter C, Hame SL (2006) Biomechanical analysis of tibial torque and knee flexion angle: implications for understanding knee injury. Sports Med 36:635–641PubMedCrossRefGoogle Scholar
  39. 39.
    Fanelli GC, Beck JD, Edson CJ (2011) Combined PCL-ACL lateral and medial side injuries: treatment and results. Sports Med Arthrosc 19:120–130PubMedCrossRefGoogle Scholar
  40. 40.
    Veltri DM, Warren RF (1994) Operative treatment of posterolateral instability of the knee. Clin Sports Med 13:615–627PubMedGoogle Scholar
  41. 41.
    Van de Velde SK, Bingham JT et al (2009) Analysis of tibiofemoral cartilage deformation in the posterior cruciate ligament-deficient knee. J Bone Joint Surg Am 91:167–175PubMedCrossRefGoogle Scholar
  42. 42.
    Skyhar MJ, Warren RF, Ortiz GJ et al (1993) The effects of sectioning of the posterior cruciate ligament and the posterolateral complex on the articular contact pressures within the knee. J Bone Joint Surg Am 75:694–699PubMedGoogle Scholar
  43. 43.
    Turner DA, Prodromos CC, Petasnick JP et al (1985) Acute injuries of the ligaments of the knee: magnetic resonance evaluation. Radiology 154:717–722PubMedGoogle Scholar
  44. 44.
    Fowler PJ, Messieh SS (1987) Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med 15:553–557PubMedCrossRefGoogle Scholar
  45. 45.
    Jung TM, Reinhardt C, Scheffler SU, Weiler A (2006) Stress radiography to measure posterior cruciate ­ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc 14:1116–1121PubMedCrossRefGoogle Scholar
  46. 46.
    Noyes FR, Barber-Westin SD (1996) Treatment of complex injuries involving the posterior cruciate and posterolateral ligaments of the knee. Am J Knee Surg 9:200–214PubMedGoogle Scholar
  47. 47.
    Heron CW, Calvert PT (1992) Three-dimensional gradient-echo MR imaging of the knee. Comparison with arthroscopy in 100 patients. Radiology 183:839–844PubMedGoogle Scholar
  48. 48.
    Hewett TE, Noyes FR, Lee MD (1997) Diagnosis of complete and partial posterior cruciate ligament ruptures: stress radiography compared with KT-1000 arthrometer and posterior drawer testing. Am J Sports Med 25(5):648–55PubMedCrossRefGoogle Scholar
  49. 49.
    Strobel MJ, Weiler A, Schulz MS, Russe K, Eichhorn HJ (2002) Fixed posterior subluxation in posterior cruciate ligament-deficient knees: diagnosis and treatment of a new clinical sign. Am J Sports Med 30:32–38PubMedGoogle Scholar
  50. 50.
    Kozanek M, Fu EC, Van de Velde SK et al (2009) Posterolateral structures of the knee in posterior cruciate ligament deficiency. Am J Sports Med 37:534–541PubMedCrossRefGoogle Scholar
  51. 51.
    Matava MJ, Ellis E, Gruber B (2009) Surgical treatment of posterior cruciate ligament tears: an evolving technique. J Am Acad Orthop Surg 17:435–446PubMedGoogle Scholar
  52. 52.
    Schulz MS, Steenlage ES, Russe K, Strobel MJ (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338PubMedCrossRefGoogle Scholar
  53. 53.
    Margheritini F, Frascari Diotallevi F, Mariani PP (2011) Posterior cruciate ligament reconstruction using an arthroscopic femoral inlay technique. Knee Surg Sports Traumatol Arthrosc 19:2033–5PubMedCrossRefGoogle Scholar
  54. 54.
    Mariani PP, Margheritini F (2006) Full arthroscopic inlay reconstruction of posterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 14:1038–44PubMedCrossRefGoogle Scholar
  55. 55.
    Polly DW Jr, Callaghan JJ, Sikes RA et al (1988) The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg 70A:192–198Google Scholar
  56. 56.
    Louisia S, Siebold R, Canty J, Bartlett RJ (2005) Assessment of posterior stability in total knee replacement by stress radiographs: prospective comparison of two different types of mobile bearing implants. Knee Surg Sports Traumatol Arthrosc 13:476–482PubMedCrossRefGoogle Scholar
  57. 57.
    Menetrey J, Garavaglia G, Fritschy D (2007) Definition, classification, rationale and treatment for PCl deficient knee. Rev Chir Orthop Reparatrice Appar Mot 93:5S70–73PubMedCrossRefGoogle Scholar
  58. 58.
    Schulz MS, Russe K, Lampakis G, Strobel MJ (2005) Reliability of stress radiography for evaluation of posterior knee laxity. Am J Sports Med 33:502–506PubMedCrossRefGoogle Scholar
  59. 59.
    Voos JE, Mauro CS, Wente T et al (2011) Posterior cruciate ligament. Anatomy, biomechanics, and outcomes. Am J Sports Med. doi: 10.1177/0363546511416316, Epub July 29, ahead of print
  60. 60.
    Torg JS, Barton TM, Pavlov H et al (1989) Natural history of the posterior cruciate ligament-deficient knee. Clin Orthop 246:208–216PubMedGoogle Scholar
  61. 61.
    Ahn JH, Yoo JC, Wang JH (2005) Posterior cruciate ligament reconstruction: double-loop hamstring tendon autograft versus Achilles tendon ­allograft–clinical results of a minimum 2-year follow-up. Arthroscopy 21:965–969PubMedCrossRefGoogle Scholar
  62. 62.
    Bergfeld JA, McAllister DR, Parker RD et al (2001) A biomechanical comparison of posterior cruciate ligament reconstruction techniques. Am J Sports Med 29:129–136PubMedGoogle Scholar
  63. 63.
    Hiraga Y, Ishibashi Y, Tsuda E, Toh HT (2006) Biomechanical comparison of posterior cruciate ligament reconstruction techniques using cyclic loading tests. Knee Surg Sports Traumatol Arthrosc 14:13–19PubMedCrossRefGoogle Scholar
  64. 64.
    Lim HC, Bae JH, Wang JH et al (2009) The biomechanical performance of bone block and soft-tissue posterior cruciate ligament graft fixation with interference screw and cross-pin techniques. Arthroscopy 25:250–256PubMedCrossRefGoogle Scholar
  65. 65.
    Mckernan DJ, Weiss JA, Deffner KT (1995) Tensile properties of gracilis, semitendinosus and patellar tendons from the same donor. Trans Orthop Res Soc 20:39Google Scholar
  66. 66.
    Markolf K, Davies M, Zoric B, McAllister D (2003) Effects of bone block position and orientation within the tibial tunnel for posterior cruciate ligament graft reconstructions: a cyclic loading study of bone-patellar tendon-bone allografts. Am J Sports Med 31:673–679PubMedGoogle Scholar
  67. 67.
    Noyes FR, Barber SD (1993) Allograft reconstruction of the anterior and posterior cruciate ligaments: report of ten-year experience and results. Instr Course Lect 42:381–396PubMedGoogle Scholar
  68. 68.
    Markolf KL, Feeley BT, Tejwani SG et al (2006) Changes in knee laxity and ligament force after sectioning the posteromedial bundle of the posterior cruciate ligament. Arthroscopy 22:1100–1106PubMedCrossRefGoogle Scholar
  69. 69.
    Race A, Amis AA (1998) PCL reconstruction. In vitro biomechanical comparison of ‘isometric’ versus single and double-bundled ‘anatomic’ grafts. J Bone Joint Surg Br 80:173–179PubMedCrossRefGoogle Scholar
  70. 70.
    Harner CD, Janaushek MA, Kanamori A et al (2000) Biomechanical analysis of a double-bundle posterior cruciate ligament reconstruction. Am J Sports Med 28:144–151PubMedGoogle Scholar
  71. 71.
    Whiddon DR, Zehms CT, Miller MD et al (2008) Double compared with single-bundle open inlay posterior cruciate ligament reconstruction in a cadaver model. J Bone Joint Surg Am 90:1820–1829PubMedCrossRefGoogle Scholar
  72. 72.
    Bergfeld JA, Graham SM, Parker RD et al (2005) A biomechanical comparison of posterior cruciate ligament reconstructions using single- and double-bundle tibial inlay techniques. Am J Sports Med 33:976–981PubMedCrossRefGoogle Scholar
  73. 73.
    Weimann A, Wolfert A, Zantop T et al (2007) Reducing the “killer turn” in posterior fixation level and smoothing the tibial aperture. Arthroscopy 23:1104–1111PubMedCrossRefGoogle Scholar
  74. 74.
    Margheritini F, Rihn JA, Mauro CS et al (2005) Biomechanics of initial tibial fixation of posterior cruciate ligament reconstruction. Arthroscopy 21:1164–1171PubMedCrossRefGoogle Scholar
  75. 75.
    Berg EE (1995) Posterior cruciate ligament tibial inlay reconstruction. Arthroscopy 11:69–76PubMedCrossRefGoogle Scholar
  76. 76.
    Ruberte Thiele RA, Campbell RB et al (2010) Biomechanical comparison of figure-of-8 versus cylindrical tibial inlay constructs for arthroscopic posterior cruciate ligament reconstruction. Arthroscopy 26:977–983PubMedCrossRefGoogle Scholar
  77. 77.
    Markolf KL, Zemanovic JR, McAllister DR (2002) Cyclic loading of posterior cruciate ligament replacements fixed with tibial tunnel and tibial inlay methods. J Bone Joint Surg Am 84:518–524PubMedCrossRefGoogle Scholar
  78. 78.
    Kim SJ, Kim TE, Jo SB, Kung YP (2009) Comparison of the clinical results of three posterior cruciate ligament reconstruction techniques. J Bone Joint Surg Am 91:2543–2549PubMedCrossRefGoogle Scholar
  79. 79.
    Zehms CT, Whiddon DR, Miller MD et al (2008) Comparison of a double bundle arthroscopic inlay and open inlay posterior cruciate ligament reconstruction using clinically relevant tools: a cadaveric study. Arthroscopy 24:472–480PubMedCrossRefGoogle Scholar
  80. 80.
    LaPrade RF, Johansen S, Wentorf FA et al (2004) An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique. Am J Sports Med 32:1405–1414PubMedCrossRefGoogle Scholar
  81. 81.
    Larson RV (2001) Isometry of the lateral collateral and popliteofibular ligaments and techniques for reconstruction using a free semitendinosus tendon graft. Oper Tech Sports Med 9:84–90CrossRefGoogle Scholar
  82. 82.
    Noyes FR, Barber-Westin SD (2007) Posterolateral knee reconstruction with an anatomical bone-patellar tendon-bone reconstruction of the fibular collateral ligament. Am J Sports Med 35:259–273PubMedCrossRefGoogle Scholar
  83. 83.
    Yoon KH, Bae DK, Ha JH, Park SW (2006) Anatomic reconstructive surgery for posterolateral instability of the knee. Arthroscopy 22:159–165PubMedCrossRefGoogle Scholar
  84. 84.
    Shelbourne KD, Carr DR (2003) Combined anterior and posterior cruciate and medial collateral ligament injury: nonsurgical and delayed surgical treatment. Instr Course Lect 52:413–418PubMedGoogle Scholar
  85. 85.
    Yoshiya S, Kuroda R, Mizuno K (2005) Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med 33:1380–1385PubMedCrossRefGoogle Scholar
  86. 86.
    Fanelli GC, Harris JD (2006) Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc 14:78–83PubMedCrossRefGoogle Scholar
  87. 87.
    Ahmad CS, Cohen ZA, Levine WN et al (2003) Co-dominance of the individual posterior cruciate ligament bundles: an analysis of bundle lengths and orientation. Am J Sports Med 31:221–225PubMedGoogle Scholar
  88. 88.
    Chhabra A, Kline AJ, Harner CD (2006) Single-bundle versus double-bundle posterior cruciate ligament reconstruction: scientific rationale and surgical technique. Instr Course Lect 55:497–507PubMedGoogle Scholar
  89. 89.
    Edwards A, Bull AM, Amis AA (2007) The attachments of the fiber bundles of the posterior cruciate ligament: an anatomic study. Arthroscopy 23:284–290PubMedCrossRefGoogle Scholar
  90. 90.
    Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint: anatomical, ­functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRefGoogle Scholar
  91. 91.
    Gollehon DL, Torzilli PA, Warren RF (1987) The role of the posterolateral and cruciate ligaments in the stability of the human knee: a biomechanical study. J Bone Joint Surg Am 69:233–242PubMedGoogle Scholar
  92. 92.
    Harner CD, Xerogeanes JW, Livesay GA et al (1995) The human posterior cruciate ligament complex: an interdisciplinary study. Ligament morphology and biomechanical evaluation. Am J Sports Med 23:736–745PubMedCrossRefGoogle Scholar
  93. 93.
    Lopes OV Jr, Ferretti M, Shen W et al (2008) Topography of the femoral attachment of the posterior cruciate ligament. J Bone Joint Surg Am 90:249–255PubMedCrossRefGoogle Scholar
  94. 94.
    Moran CJ, Poynton AR, Moran R, Brien MO (2006) Analysis of meniscofemoral ligament tension during knee motion. Arthroscopy 22:362–366PubMedCrossRefGoogle Scholar
  95. 95.
    Morgan CD, Kalman VR, Grawl DM (1997) The anatomic origin of the posterior cruciate ligament: where is it?–reference landmarks for PCL reconstruction. Arthroscopy 13:325–331PubMedCrossRefGoogle Scholar
  96. 96.
    Nagasaki S, Ohkoshi Y, Yamamoto K et al (2006) The incidence and cross-sectional area of the meniscofemoral ligament. Am J Sports Med 34:1345–1350PubMedCrossRefGoogle Scholar
  97. 97.
    Tajima G, Nozaki M, Iriuchishima T et al (2009) Morphology of the tibial insertion of the posterior cruciate ligament. J Bone Joint Surg Am 91:859–866PubMedCrossRefGoogle Scholar
  98. 98.
    Veltri DM, Warren RF (1993) Isolated and combined posterior cruciate ligament injuries. J Am Acad Orthop Surg 1:67–75PubMedGoogle Scholar
  99. 99.
    Clancy WG Jr, Shelbourne KD, Zoellner GB et al (1983) Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament: report of a new procedure. J Bone Joint Surg Am 65:310–322PubMedGoogle Scholar
  100. 100.
    Harner CD, Janaushek MA, Kanamori A et al (2000) Biomechanical analysis of a doublebundle posterior cruciate ligament reconstruction. Am J Sports Med 28:144–151PubMedGoogle Scholar
  101. 101.
    Hermans S, Corten K, Bellemans J (2009) Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. Am J Sports Med 37:1499–507PubMedCrossRefGoogle Scholar
  102. 102.
    Berg EE (1995) Posterior cruciate ligament tibial inlay reconstruction. Arthroscopy 11:69–76PubMedCrossRefGoogle Scholar
  103. 103.
    Thomann YR, Gaechter A (1994) Dorsal approach for reconstruction of the posterior cruciate ligament. Arch Orthop Trauma Surg 113:142–8PubMedCrossRefGoogle Scholar
  104. 104.
    Margheritini F, Mauro CS, Rihn JA et al (2004) Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: analysis of knee kinematics and graft in situ forces. Am J Sports Med 32:587–593PubMedCrossRefGoogle Scholar
  105. 105.
    MacGillivray JD, Stein BE, Park M et al (2006) Comparison of tibial inlay versus transtibial ­techniques for isolated posterior cruciate ligament reconstruction: minimum 2-year followup. Arthroscopy 22:320–328PubMedCrossRefGoogle Scholar
  106. 106.
    Ahn JH, Nha KW, Kim YC et al (2006) Arthroscopic femoral tensioning and posterior cruciate ligament reconstruction in chronic posterior cruciate ligament injury. Arthroscopy 22:341.e1–4CrossRefGoogle Scholar
  107. 107.
    Jung YB, Jung HJ, Tae SK, Lee YS, Yang DL (2006) Tensioning of remnant posterior cruciate ligament and reconstruction of anterolateral bundle in chronic posterior cruciate ligament injury. Arthroscopy 22:329–38PubMedCrossRefGoogle Scholar
  108. 108.
    Giffin JR, Stabile KJ, Zantop T, Vogrin TM, Woo SL, Harner CD (2007) Importance of tibial slope for stability of the posterior cruciate ligament deficient knee. Am J Sports Med 35:1443–9PubMedCrossRefGoogle Scholar
  109. 109.
    Fanelli GC, Edson CJ (1995) Posterior cruciate ligament injuries in trauma patients: part II. Arthroscopy 11:526–597PubMedCrossRefGoogle Scholar
  110. 110.
    Wascher DC, Grauer JD, Markoff KL (1993) Biceps tendon tenodesis for posterolateral instability of the knee: an in vitro study. Am J Sports Med 21:400–406PubMedCrossRefGoogle Scholar
  111. 111.
    Harner CD, Vogrin TM, Hoher J et al (2000) Biomechanical analysis of a posterior cruciate ligament reconstruction: deficiency of the posterolateral structures as a cause of graft failure. Am J Sports Med 28:32–39PubMedGoogle Scholar

Copyright information

© ESSKA 2012

Authors and Affiliations

  • Tom Van Hoof
    • 1
  • Michiel Cromheecke
    • 2
  • Thomas Tampere
    • 2
  • Katharina D’herde
    • 1
  • Jan Victor
    • 2
  • Peter C. M. Verdonk
    • 2
    • 3
  • Jacques Menetrey
    • 4
  • Sven Scheffler
    • 5
  • Patrick Djian
    • 6
  • Konstantinos G. Makridis
    • 6
  • Fabrizio Margheritini
    • 7
  1. 1.Department of AnatomyGhent UniversityGhentBelgium
  2. 2.Department of Orthopaedic Surgery and TraumatologyGhent UniversityGhentBelgium
  3. 3.Poli 5 2e verdiep, Department of Orthopaedic SurgeryUZGENTGhentBelgium
  4. 4.Unité d’orthopédie et traumatologie du sport, Service de chirurgie orthopédique et traumatologie de l’appareil moteurHôpitaux Universitaires de GenèveGenève 14Switzerland
  5. 5.Knie- und SportorthopädieChirurgisch-Orthopädischer Praxisverbund (COPV)BerlinGermany
  6. 6.Institut GoetheParisFrance
  7. 7.University of Rome ‘Foro Italico’RomeItaly

Personalised recommendations