The effects of sequential sectioning of defined posterior cruciate ligament fiber regions on translational knee motion.
BACKGROUND
Recent studies have shown that the posterior cruciate ligament (PCL) is composed of a continuum of fiber regions that display characteristic mechanical behavior under different motion and loading conditions.


OBJECTIVE
The anterior, central, and posterior fiber regions of the PCL differentially contribute to control of posterior translation of the tibia.


METHODS
Controlled laboratory study.


METHODS
Nine intact, fresh-frozen cadaveric knees were instrumented with excursion wires implanted within the anterior, central, and posterior fiber regions of the PCL. In groups of 3, patterns of incremental posterior tibial translation using a 74-N posterior force were analyzed as a function of the variable linear separation distance between tibial and femoral fiber region attachment sites during posterior drawer testing at knee flexion angles of 20 degrees and 90 degrees before and after sequential fiber region section.


RESULTS
At 20 degrees of knee flexion, there was no statistical difference in the relatively small amount of posterior tibial translation, regardless of whether the anterior, central, or posterior fibers were alone transected (P = .350). At 90 degrees of knee flexion, whether the posterior fibers were cut first, second, or third (order of section), the incremental difference in posterior tibial translation this produced was significantly different (P = .039). For the fiber regions combined, the third fiber region section resulted in a significantly larger incremental translation than did either the first or second section with the knee flexed 90 degrees (P = .001). After transection of all fiber regions, significantly more total posterior tibial translation occurred at 90 degrees versus 20 degrees of flexion (P = .002).


CONCLUSIONS
This study shows that fiber regions within the PCL have unique characteristics and behave differently in response to posterior drawer forces.


CONCLUSIONS
This study provides additional information on the complex mechanical behavior of the PCL and suggests that some partial tears (ie, those involving 1 or 2 fiber regions) may only result in minimal posterior translation during drawer testing at 90 degrees .
Department of Orthopaedic Surgery, Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA 92134-1112, USA. dana.covey@med.navy.mil
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Covey
Alexander A
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Sapega
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Riffenburgh
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000033:anatomy & histology / Q000502:physiology*; D013977:Tibia / Q000502:physiology*