Posterior cruciate ligament architecture: evaluation under microsurgical dissection.
OBJECTIVE
Our objective was to verify the fiber anatomy of the posterior cruciate ligament (PCL) and to measure the main dimensions and the femoral and tibial attachment site distances of the ligament after microsurgical dissection. We hypothesized that PCL anatomy is more complex than the 2 traditionally characterized bands.


METHODS
This is a purely anatomic description of microdissections of the PCL, focused on the fine anatomy of the ligament.


METHODS
Twenty-four fresh-frozen cadaveric knees were dissected using magnifying loupes and an operative microscope, being careful to avoid creating artificially separated bundles. The main dimensions of the PCL were measured using a micrometer.


RESULTS
The anterior, central, posterior-longitudinal, and posterior-oblique were the 4 fiber regions identified based on their orientation and the osseous sites of their insertions. These were partially separable anatomically but were functionally distinct. The anterior and central fiber regions made up the bulk of the ligament, while the remaining 15% consisted of the posterior fiber regions. During manual joint motion, the behavior of these fiber regions was observed. The anterior fiber region appeared to be the most nonisometric and remained in tension mainly between 30 degrees and 90 degrees of flexion. The posterior fiber regions appeared to be the most isometric (especially the posterior-oblique) and remained in tension mainly in extension and partially in deep flexion. The central fiber region appeared to have an intermediate behavior and remained in tension mainly between 30 degrees and 120 degrees of flexion. Additionally, it appeared to be the widest of all fiber regions.


CONCLUSIONS
These findings should be of interest and help in interpreting some of the anatomy encountered during arthroscopic examination of the PCL, both from the anterior and posterior lateral portals. Furthermore, this information should prove useful in selecting treatment for the PCL.
Makris
C A
CA
Department of Orthopaedic Surgery, University of Ioannina Medical School, Ioannina, Greece. grakos@otenet.gr
Georgoulis
A D
AD
Papageorgiou
C D
CD
Moebius
U G
UG
Soucacos
P N
PN
D002102:Cadaver; D004210:Dissection; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology / Q000502:physiology; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000033:anatomy & histology* / Q000502:physiology / Q000601:surgery; D013583:Synovial Membrane / Q000033:anatomy & histology