Cutting-Edge Posterior Cruciate Ligament Reconstruction Principles

Document Type : CURRENT CONCEPTS REVIEW

Authors

1 1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A 2 University of North Dakota School of Medicine and Health Sciences, 1301 N Columbia Rd, Grand Forks, ND 58203 U.S.A

2 1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A 3 University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 U.S.A

3 1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A 4 Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC 20007 U.S.A

4 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 U.S.A

Abstract

The posterior cruciate ligament (PCL) is the primary stabilizer to posterior tibial translation of the knee. PCL injuries classically occur as the result of a posteriorly directed force against the anterior part of the tibia. They frequently occur as multiligament injuries or with concomitant cartilage or meniscal injuries. The posterior drawer test is highly sensitive and specific for PCL injuries. Posterior stress radiography is critical for objective assessment of posterior tibial translation and grading of PCL injuries. Grade I and II injuries may be treated nonoperatively, but in general isolated grade III injuries and multiligament injuries require surgical intervention due to the inevitable development of osteoarthritis. Anatomical and biomechanical studies have led to the development of an anatomic double-bundle reconstruction, which has been reported in clinical outcome studies to result in better functional and objective outcomes than single-bundle reconstructions. This article focuses on the clinically and surgically relevant anatomy and biomechanics of the PCL, diagnosis and treatment of PCL injuries, and a description of the anatomic double-bundle PCL reconstruction technique.

Keywords


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