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The posterior cruciate ligament: a study on its bony and soft tissue anatomy using novel 3D CT technology

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

Abstract

Purpose

The bony insertion sites of the PCL have been studied and described extensively using 2D technology such as macroscopic images, plain radiograph, computerized tomography (CT) and MRI. The purpose of this study is to visualize both the tibial and the femoral bony insertion sites but also the soft tissue anatomy of the native PCL using novel 3D CT imaging. In addition, new concepts of best-fit cylinder and central axis are introduced and evaluated.

Methods

Nine unpaired knees of embalmed cadavers were used in this study. Following the dissection process, the PCL was injected with a contrast medium for computed tomography (CT) imaging. The obtained CT images were segmented and rendered in 3D allowing morphological and morphometric analysis of PCL. Femoral and tibial footprint surface area, best-fit PCL-cylinder intersection area, best-fit PCL-cylinder/footprint coverage ratio, best-fit PCL-cylinder central axis projections at the tibial and femoral footprint were used to describe the anatomy of the PCL.

Results

Mean footprint surface area of the tibial and femoral footprint were 189.1 and 293.3 mm², respectively. The mean diameter of the best-fit cylinder was 10.5 mm. The mean coverage of the best-fit cylinder on the tibial and femoral footprint was 76.5 and 46.5, respectively. The best-fit cylinder central axis was located in the anterolateral AL bundle footprint on the femur and more centrally in the PCL footprint on the tibia.

Conclusion

This study is the first to describe the detailed anatomy of the human PCL with respect to its course and footprints using a 3D approach. It confirms the large difference between the tibial and the femoral footprint area with the former being significantly smaller. In addition, a large inter-patient variability is observed. The best-fit cylinder and central axis concept offer additional insights into the optimal tunnel placement at the tibia and femoral footprint in order to cover the largest portion of the native PCL soft tissue.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Ghent University, Ghent, Belgium

    Michiel Cromheecke, Thomas Tampere & Jan Victor

  2. Department of Anatomy, Ghent University, Ghent, Belgium

    Tom Van Hoof & Katharina D’herde

  3. Department of Physiotherapy and Orthopaedic Surgery, Faculty of Medicine, Ghent University, Ghent, Belgium

    Peter C. M. Verdonk

  4. Department of Orthopaedic Surgery, Monica Hospitals, Harmoniestraat 68, 2018, Antwerpen, Belgium

    Peter C. M. Verdonk

Authors
  1. Tom Van Hoof
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  2. Michiel Cromheecke
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  3. Thomas Tampere
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  4. Katharina D’herde
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  5. Jan Victor
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  6. Peter C. M. Verdonk
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Corresponding author

Correspondence to Peter C. M. Verdonk.

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Van Hoof, T., Cromheecke, M., Tampere, T. et al. The posterior cruciate ligament: a study on its bony and soft tissue anatomy using novel 3D CT technology. Knee Surg Sports Traumatol Arthrosc 21, 1005–1010 (2013). https://doi.org/10.1007/s00167-012-2332-8

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  • DOI: https://doi.org/10.1007/s00167-012-2332-8

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