Clin Orthop Surg.  2013 Dec;5(4):256-262. 10.4055/cios.2013.5.4.256.

Posterior Cruciate Ligament: Focus on Conflicting Issues

• Lee YS
• Jung YB

• KMID: 1787027
• DOI: http://doi.org/10.4055/cios.2013.5.4.256

Abstract

There is little consensus on how to optimally reconstruct the posterior cruciate ligament (PCL) and the natural history of injured PCL is also unclear. The graft material (autograft vs. allograft), the type of tibial fixation (tibial inlay vs. transtibial tunnel), the femoral tunnel position within the femoral footprint (isometric, central, or eccentric), and the number of bundles in the reconstruction (1 bundle vs. 2 bundles) are among the many decisions that a surgeon must make in a PCL reconstruction. In addition, there is a paucity of information on rehabilitation after reconstruction of the PCL and posterolateral structures. This article focused on the conflicting issues regarding the PCL, and the scientific rationales behind some critical points are discussed.

Keyword

Knee; Posterior cruciate ligament; Biomechanics; Outcome; Rehabilitation

MeSH Terms

Biomechanical Phenomena
Humans
Knee Joint/*surgery
Orthopedic Procedures/*methods
Posterior Cruciate Ligament/*surgery
Reconstructive Surgical Procedures/*methods
Treatment Outcome

Figure

• 

  Fig. 1 Schematic drawing: the remnant posterior cruciate ligament would work like a soft tissue cushion to prevent the killer turn effect at the tunnel orifice.

• 

  Fig. 2 Remnant preserving posterior cruciate ligament (PCL) reconstruction. (A) The remnant PCL is preserved and the anterolateral bundle is reconstructed with autogenous hamstring 4 bundles. (B) Postoperative 2 years: the reconstructed PCL is well remodeled and it is difficult to differentiate between the graft and remnant PCL.

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