title: Posterior tibial translation resulting from the posterior drawer manoeuver in cadaveric knee specimens: a systematic review.
abstract: OBJECTIVE
  The purpose of this systematic review of cadaver-based biomechanical studies is to accurately quantify how much posterior tibial translation occurs during posterior drawer testing in normal and PCL-deficient knees.
  
  
  METHODS
  A search of the electronic databases, MEDLINE and EMBASE, was performed to identify relevant cadaveric studies that reported posterior tibial translation during posterior drawer testing. Studies were combined to determine overall increase in posterior tibial translation after PCL sectioning at 90° of flexion. Methodological quality of included studies was assessed by two reviewers using a novel clinometric tool. An intraclass correlation coefficient with 95 % confidence intervals (CIs) was used to determine agreement between reviewers on quality scores.
  
  
  RESULTS
  Combined analysis of 244 cadaveric specimens from 23 studies in which the PCL was sectioned yielded a mean net increase in tibial translation of 10.7 mm (95 % CI 9.68-11.8) with posterior drawer testing. Posterior tibial translation among cadaveric specimens with no disruption to any ligamentous structures was found to be 5.4 mm (95 % CI 4.3-6.6).
  
  
  CONCLUSIONS
  Cadaveric data support previous study findings of >8 mm of posterior tibial translation on stress radiographs being indicative of isolated PCL insufficiency. Use of fixed reference points and strict control of tibial rotation are imperative to ensure accurate results in cadaveric studies and in the clinical setting when performing the posterior drawer examination.
  
  
  METHODS
  III.
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, 1200 Main Street West, 4E175, Hamilton, ON, L8S 3Z5, Canada.
authors.forename: Marcin
authors.initials: M
authors.lastname: Kowalczuk
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, 1200 Main Street West, 4E175, Hamilton, ON, L8S 3Z5, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Leblanc
authors.affiliation: Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Rothrauff
authors.affiliation: Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Debski
authors.affiliation: Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA.|Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Volker
authors.initials: V
authors.lastname: Musahl
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, 1200 Main Street West, 4E175, Hamilton, ON, L8S 3Z5, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Simunovic
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, 1200 Main Street West, 4E175, Hamilton, ON, L8S 3Z5, Canada. ayenif@mcmaster.ca.
authors.forename: Olufemi R
authors.initials: OR
authors.lastname: Ayeni
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology*; D010808:Physical Examination / Q000379:methods*; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000503:physiopathology
keywords: Knee instability; Posterior cruciate ligament injury; Posterior cruciate ligament rupture; Posterior drawer
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