Posterior cruciate ligament tibial attachment anatomy and radiographic landmarks for tibial tunnel placement in PCL reconstruction.

The posterior cruciate ligament (PCL) was dissected in 12 frozen human cadaver knees. The tibial attachment was radiographically mapped and guide wires placed on the distal-lateral bulk of the ligament's tibial attachment. Radiographic landmarks were then described on the anteroposterior and lateral radiographs to assist in tibial tunnel guide wire placement in PCL reconstruction. The radiographic site corresponding to the posterior ridge of the tibial plateau approximately 1 cm below the joint line and a few millimeters lateral to the center of the lateral tibial tubercle will reliably confirm tibial tunnels in PCL reconstruction.