Steadman Philippon Research Institute, The Steadman Clinic, Vail, Colorado, USA


The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior
stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL
injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become
an important and validated objective measure in surgical decision making and post-operative assessment. Isolated
grade I or II PCL injuries can usually be treated non-operatively. However, when acute grade III PCL ruptures occur
together with other ligamentous injury and/or repairable meniscal body/root tears, surgery is indicated. Anatomic singlebundle
PCL reconstruction (SB-PCLR) typically restores the larger anterolateral bundle (ALB) and represents the most
commonly performed procedure. Unfortunately, residual posterior and rotational tibial instability after SB-PCLR has
led to the development of an anatomic double-bundle (DB) PCLR to restore the native PCL footprint and co-dominant
behavior of the anterolateral and posteromedial bundles and re-establish normal knee kinematics. The purpose of this
article is to review the pertinent details regarding PCL anatomy, biomechanics, injury diagnosis and treatment options,
with a focus on arthroscopically assisted DB-PCLR.


Main Subjects

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