Literature DB >> 16012495

The anatomic characteristics of the tibial insertion of the posterior cruciate ligament.

David M Sheps1, David Otto, Mark Fernhout.   

Abstract

PURPOSE: The purpose of the study was to better define the tibial insertion of the posterior cruciate ligament (PCL) and to identify landmarks that could be used to aid in placement of independent tibial tunnels for a 2-bundle PCL reconstruction. TYPE OF STUDY: Descriptive anatomic study.
METHODS: Ten knees from 8 cadavers were dissected and the PCL was identified. The ligament was peeled away from its insertion and the sides of the insertion site were measured and recorded. The 4 corners of the insertion site were identified and marked. Observations were made of the morphology of the insertion site and the presence of any reproducible anatomic landmarks. A note was made of landmarks that could be easily identified on all of the specimens by direct vision and by palpation with a probe.
RESULTS: The ligament consisted of 2 regions, 1 anterolateral, and 1 posteromedial, with a gradual change in the laxity of the ligament as the knee was passed through flexion and extension. The insertion site was situated in a depression between the plateaus of the tibia and extended below the articular surface. The average length +/- standard deviation of the 4 sides was 128 +/- 21.2 mm (medial side), 107 +/- 26.5 mm (superior side), 160 +/- 30.0 mm (lateral side), and 169 +/- 34.5 mm (inferior side). The shape and sides of the insertion site were visually similar among the 10 specimens. The superolateral and superomedial corners were both represented by depressions and a reproducible ridge represented the inferior border. These structures could be visualized as well as palpated on all specimens.
CONCLUSIONS: Based on the findings of this study, we describe the anatomic characteristics of the tibial footprint of the PCL. Anatomic reference points that represent the corners of the tibial insertion of the PCL were identified by direct vision or palpation consistently on all specimens included in the study. These reference points could potentially aid in the placement of an anterolateral and posteromedial tibial tunnel for a 2 tibial tunnel PCL reconstruction. CLINICAL RELEVANCE: Reproducible anatomic reference points exist at the tibial insertion of the PCL that can be identified by direct vision and palpation. These reference points may potentially aid in the placement of separate tibial tunnels for a 2-bundle PCL reconstruction.

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Mesh:

Year:  2005        PMID: 16012495     DOI: 10.1016/j.arthro.2005.04.105

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  10 in total

1.  Partial resection of the PCL insertion site during tibial preparation in cruciate-retaining TKA.

Authors:  Hans Feyen; Nick Van Opstal; Johan Bellemans
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2012-04-22       Impact factor: 4.342

2.  Radiological evaluation of the anterolateral and posteromedial bundle insertion sites of the posterior cruciate ligament.

Authors:  Stephan Lorenz; Florian Elser; Peter U Brucker; Tobias Obst; Andreas B Imhoff
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2009-03-24       Impact factor: 4.342

3.  Mean tensile strength of the PCL in TKA depends on the preservation of the tibial insertion site.

Authors:  N Van Opstal; H Feyen; J P Luyckx; J Bellemans
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-10-12       Impact factor: 4.342

4.  MRI study of the cruciate ligaments and menisco-femoral ligaments of the knee.

Authors:  F Corbí-Aguirre; F Forriol
Journal:  Musculoskelet Surg       Date:  2022-08-08

5.  Cruciate-retaining total knee arthroplasty: How much of the PCL is really retained?

Authors:  Trifon Totlis; Michael Iosifidis; Ioannes Melas; Konstantinos Apostolidis; Alexios Agapidis; Nikolaos Eftychiakos; Dimitrios Alvanos; Anastasios Kyriakidis
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2016-05-03       Impact factor: 4.342

6.  The morphometry of soft tissue insertions on the tibial plateau: data acquisition and statistical shape analysis.

Authors:  Liying Zheng; Christopher D Harner; Xudong Zhang
Journal:  PLoS One       Date:  2014-05-02       Impact factor: 3.240

Review 7.  Systematic review of cadaveric studies on anatomic posterior cruciate ligament reconstruction: the landmarks in anatomic posterior cruciate ligament reconstruction.

Authors:  Dong Yeong Lee; Dong Hee Kim; Jin Sung Park; Dae Cheol Nam; Seong Hee Cho; Jin Hoon Jeong; Sun Chul Hwang
Journal:  Knee Surg Relat Res       Date:  2014-12-02

8.  Anatomic Double Bundle Posterior Cruciate Ligament Reconstruction Using an Internal Splint.

Authors:  J Banks Deal; Dexter C Allen; Craig R Bottoni
Journal:  Arthrosc Tech       Date:  2020-06-15

9.  Tibial Insertions of the Posterior Cruciate Ligament: Topographic Anatomy and Morphometric Study.

Authors:  Julio Cesar Gali; Hector Campora de Sousa Oliveira; Bruno Cesar Bracher Lisboa; Bruno DiSerio Dias; Fabiana de Godoy Casimiro; Edie Benedito Caetano
Journal:  Rev Bras Ortop       Date:  2013-08-13

Review 10.  Tibial tunnel placement in posterior cruciate ligament reconstruction: a systematic review.

Authors:  J-D Nicodeme; C Löcherbach; B M Jolles
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2013-06-16       Impact factor: 4.342

  10 in total

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