Unique Anatomic Feature of the Posterior Cruciate Ligament in Knees Associated With Osteochondritis Dissecans.
BACKGROUND
Osteochondritis dissecans (OCD) of the knee is a disorder in juveniles and young adults; however, its etiology still remains unclear. For OCD at the medial femoral condyle (MFC), it is sometimes observed that the lesion has a connection with fibers of the posterior cruciate ligament (PCL). Although this could be important information related to the etiology of MFC OCD, there is no report examining an association between the MFC OCD and the PCL anatomy.


OBJECTIVE
To investigate the anatomic features of knees associated with MFC OCD, focusing especially on the femoral attachment of the PCL, and to compare them with knees associated with lateral femoral condyle (LFC) OCD and non-OCD lesions.


METHODS
Case-control study; Level of evidence, 3.


METHODS
We retrospectively reviewed 39 patients (46 knees) with OCD lesions who had undergone surgical treatment. Using magnetic resonance imaging (MRI) scans, the PCL attachment at the lateral wall of the MFC was measured on the coronal sections, and the knee flexion angle was also measured on the sagittal sections. As with non-OCD knees, we reviewed and analyzed 25 knees with anterior cruciate ligament (ACL) injuries and 16 knees with meniscal injuries.


RESULTS
MRIs revealed that the femoral PCL footprint was located in a significantly more distal position in the patients with MFC OCD compared with patients with LFC OCD and ACL and meniscal injuries. There was no significant difference in knee flexion angle among the 4 groups.


CONCLUSIONS
The PCL in patients with MFC OCD attached more distally at the lateral aspect of the MFC compared with knees with LFC OCD and ACL and meniscal injuries.
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Masakazu
M
Ishikawa
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Nobuo
N
Adachi
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Masahiro
M
Yoshikawa
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Atsuo
A
Nakamae
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Tomoyuki
T
Nakasa
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Yasunari
Y
Ikuta
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Seiju
S
Hayashi
Laboratory of Musculoskeletal Functional Research and Regeneration, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Masataka
M
Deie
Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Mitsuo
M
Ochi
anatomic feature; femoral footprint; osteochondritis dissecans; posterior cruciate ligament