Combined Posterior Cruciate Ligament and Superficial Medial Collateral Ligament Knee Reconstruction: Avoiding Tunnel Convergence
Abstract Combined posterior cruciate ligament (PCL) and medial collateral ligament (MCL) injuries represent a complex pathology that requires a thorough clinical and radiographic examination to diagnose and identify all injured structures. Anatomic reconstruction of the injured ligaments is [...]
Editorial Commentary: Arthroscopic Outcomes Are Equal to Open Popliteus Tendon Reconstructions, but Do Not Forget That the Goal Is a Stable Posterior Cruciate Ligament Reconstruction
Abstract: Arthroscopic popliteus tendon reconstructions were found to be equally as efficacious as open popliteus reconstructions in restoring external rotation stability. However, when the procedure was combined with a posterior cruciate ligament (PCL) reconstruction, the PCL reconstruction still [...]
Quantitative mapping of acute and chronic PCL pathology with 3 T MRI: a prospectively enrolled patient cohort
Background The diagnosis of incomplete acute and chronic posterior cruciate ligament (PCL) tears can be challenging with conventional magnetic resonance (MR) imaging, particularly for injuries in which the ligament appears continuous as occurs with chronic PCL tears that [...]
Tibial Slope and Its Effect on Graft Force in Posterior Cruciate Ligament Reconstructions
Background: A flattened posterior tibial slope may cause excessive unwanted stress on the posterior cruciate ligament (PCL) reconstruction graft and place patients at risk for PCL reconstruction graft failure. To date, there is a paucity of biomechanical studies [...]
Decreased Posterior Tibial Slope Does Not Affect Postoperative Posterior Knee Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction
Background Recent clinical studies identified sagittal plane posterior tibial slope as a risk factor for increased postoperative lax- ity after single-bundle posterior cruciate ligament reconstruction (PCLR). Purpose/Hypothesis To retrospectively compare the degree of posterior tibial slope and its [...]
Posterior Tibial Slope and Risk of Posterior Cruciate Ligament Injury
Background Recent biomechanical studies have identified sagittal plane posterior tibial slope as a potential risk factor for pos- terior cruciate ligament (PCL) injury because of its effects on the kinematics of the native and surgically treated knee. However, [...]
Posterior Cruciate Ligament: Current Concepts Review
ABJS 2018 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 [...]
Posterior Cruciate Ligament Injuries of the Knee at the National Football League Combine: An Imaging and Epidemiology Study
Purpose: To determine the epidemiology by player position, examination, imaging findings, and associated injuries of posterior cruciate ligament (PCL) injuries in players participating in the National Football League (NFL) Combine. Methods: All PCL injuries identified at the NFL [...]
Anatomic Posterior Cruciate Ligament Reconstruction: State of the Art
JISAKOS 2016 The posterior cruciate ligament (PCL) is recognized to be the main posterior stabilizer of the knee. PCL injuries are most commonly associated with concurrent ligament injuries and also with a high prevalence of chondral and meniscal [...]
Quantifiable Imaging Biomarkers for Evaluation of the Posterior Cruciate Ligament Using 3-T Magnetic Resonance Imaging
OJSM 2016 Quantitative magnetic resonance imaging (MRI) techniques, such as T2 and T2 star (T2*) mapping, have been used to evaluate ligamentous tissue in vitro and to identify significant changes in structural integrity of a healing ligament. These [...]
Emerging Updates on the Posterior Cruciate Ligament
AJSM 2015 The posterior cruciate ligament (PCL) is recognized as an essential stabilizer of the knee. However, the complexity of the ligament has generated controversy about its definitive role and the recommended treatment after injury. A proper understanding of the [...]
The Supine Internal Rotation Test
OJSM 2015 Biomechanical studies have reported that the posterior cruciate ligament (PCL) functions as a restraint against excessive tibial internal rotation at higher degrees of knee flexion. The purpose of this study is to investigate the use of a supine [...]
Posterior Cruciate Ligament Graft Fixation Angles, Part II
AJSM 2014 Prior studies have suggested that anatomic double-bundle (DB) posterior cruciate ligament reconstruction (PCLR) reduces residual laxity compared with the intact state better than single-bundle PCLR. Although the anterolateral bundle (ALB) and posteromedial bundle (PMB) reportedly act codominantly, few [...]
Posterior Cruciate Ligament Graft Fixation Angles, Part I
AJSM 2014 Currently, no consensus exists for the optimal graft fixation angle for anatomic single-bundle (SB) posterior cruciate ligament reconstructions (PCLRs). Additionally, direct graft forces have not been measured. Alternative graft fixation angles and the resultant graft forces should be [...]
Quantification of Functional Brace Forces for Posterior Cruciate Ligament Injuries on the Knee Joint: an In Vivo Investigation
KSSTA 2014 The purpose of this study is to counteract posterior translation of the tibia with an anterior force on the posterior proximal tibia that has been demonstrated clinically to improve posterior knee laxity following posterior cruciate ligament (PCL) injury. [...]
Radiographic Landmarks for Tunnel Positioning in Posterior Cruciate Ligament Reconstructions
AJSM 2013 Consistent radiographic guidelines for tunnel placement in single or double-bundle posterior cruciate ligament (PCL) reconstructions are not well defined. Quantitative guidelines reporting the location of the individual PCL bundle attachments would aid in intraoperative tunnel placement and postoperative [...]
Posterior Cruciate Ligament Tears – Functional and Postop Rehab
KSSTA 2012 This study evaluated the current literature for both functional and post-operative rehabilitation for PCL tears. A very comprehensive summary of the current treatment for acute PCL tears, both non-operatively and operatively, as well as post-operative treatment of PCL reconstructions was [...]
Historical Perspective of PCL Bracing
KSSTA 2012 This manuscript went into detail about the history of PCL braces, why PCL braces are needed, and what future research is necessary to improve on PCL bracing. Basically, we found that most current braces do not place sufficient force on [...]
Arthroscopic Anatomy of the PCL
THE JOURNAL OF BONE AND JOINT SURGERY 2012 The clock-face method to identify the femoral posterior cruciate ligament (PCL) attachment has poor accuracy and reproducibility. Measurements of clinically relevant anatomic structures would provide more useful surgical guidance. The purpose of this [...]
Double Bundle PCL Technique and Outcomes
THE JOURNAL OF BONE AND JOINT SURGERY 2011 A variety of techniques have been developed to improve clinical outcomes and objective knee stability following posterior cruciate ligament (PCL) reconstruction. Additional refinements in surgical and rehabilitation techniques are necessary for improvement [...]
Radiographic Identification of the Primary Medial Knee Structures
JOURNAL OF BONE AND JOINT SURGERY 2009 Radiographic landmarks for medial knee attachment sites during anatomic repairs or reconstructions are unknown. If identified, they could assist in the preoperative evaluation of structure location and allow for postoperative assessment of reconstruction [...]