Anatomical and biomechanical considerations of the PCL

Journal of Sport Rehabilitation

Volumn 8, Issue 4, 1999, Pages 260-278

  Harner, Christopher D ^a   Vogrin, Tracy M ^a   Woo, Savio L Y ^a  

^a UNIVERSITY OF PITTSBURGH   (United States)

Author keywords

In situ forces; Knee kinematics; PCL reconstruction; Posterior cruciate ligament; Posterolateral structures

Indexed keywords

ARTICLE; BIOMECHANICS; FUNCTIONAL ANATOMY; HUMAN; KNEE ARTHROPLASTY; KNEE INSTABILITY; KNEE LIGAMENT INJURY; SPORT INJURY; SURGICAL ANATOMY; SURGICAL TECHNIQUE; TENSILE STRENGTH;

EID: 0032700664     PISSN: 10566716     EISSN: None     Source Type: Journal    
DOI: 10.1123/jsr.8.4.260     Document Type: Article

References (71)

1. Bach, B.R., D.J. Daluga, R. Mikosz, T.P. Andriacchi, and R. Seidl. Force displacement characteristics of the posterior cruciate ligament. Am. J. Sports Med. 20:67-72, 1992.
2. Barry, D., and A.M. Ahmed. Design and performance of a modified buckle transducer for the measurement of ligament tension. J. Biomech. Eng. 108:149-152, 1986.
3. Burns, W.C., L.F. Draganich, M. Pyevich, and B. Reider. The effect of femoral tunnel position and graft tensioning technique on posterior laxity of the posterior cruciate ligament-reconstructed knee. Am. J. Sports Med. 23:424-430, 1995.
4. Clancy, W.G., and L.J. Bisson. PCL Reconstruction Using Two Femoral Tunnels and Two Separate Grafts. New Orleans: American Academy of Orthopaedic Surgeons, 1998.
5. Clancy, W.G., K.D. Shelbourne, G.B. Zoellner, J.S. Keene, B. Reider, and T.D. Rosenberg. Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament. J. Bone Joint Surg. Am. 65A:310-322, 1983.
6. Clancy, W.G., and T.B. Sutherland. Combined posterior cruciate ligament injuries. Clin. Sports Med. 13:629, 1994.
7. Covey, D.C., A.A. Sapega, G.M. Sherman, and J.S. Torg. Testing for "isometry" during posterior cruciate ligament reconstruction. Trans. ORS 17:665, 1992.
8. Cross, M.J., and J.F. Powell. Long-term followup of posterior cruciate ligament rupture: A study of 116 cases. Am. J. Sports Med. 12:292-297, 1984.
9. Dandy, D.J., and R. Pusey. The long-term results of unrepaired tears of the posterior cruciate ligament. J. Bone Joint Surg. Br. 64B:92-94, 1982.
10. Dorlot, J.M., P. Christel, L. Sedel, and J. Witvoet. The displacement of the bony insertion sites of the cruciate ligaments during flexion of the knee. Trans. ORS 8:328, 1983.
11. Dürselen, L., L. Claes, and H. Kiefer. The influence of muscle forces and external loads on cruciate ligament strain. Am. J. Sports Med. 23:129-136, 1995.
12. Fanelli, G.C., and C.J. Edson. Posterior cruciate ligament injuries in trauma patients: Part II. Arthroscopy 11:526-529, 1995.
13. Fowler, P.J., and S.S. Messieh. Isolated posterior cruciate ligament injuries in athletes. Am. J. Sports Med. 15:553-557, 1987.
14. Fox, R.J., C.D. Harner, M. Sakane, G.J. Carlin, and SL-Y. Woo. Determination of the in situ forces in the human posterior cruciate ligament using robotic technology - A cadaveric study. Am. J. Sports Med. 26:395-401, 1998.
15. Fujie, H., G.A. Livesay, SL-Y. Woo, S. Kashiwaguchi, and G. Blomstrom. The use of a universal force-moment sensor to determine in-situ forces in ligaments: A new methodology. J. Biomech. Eng. 117:1-19, 1995.
16. Fujie, H., K. Mabuchi, SL-Y. Woo, G.A. Livesay, S. Arai, and Y. Tsukamoto. The use of robotics technology to study human joint kinematics: A new methodology. J. Biomech. Eng. 115:211-217, 1993.
17. Galloway, M.T., E.S. Grood, J.N. Mehalik, M. Levy, S.C. Saddler, and F.R. Noyes. Posterior cruciate ligament reconstruction: In vitro study of femoral and tibial graft placement. Am. J. Sports Med. 24:437-445, 1996.
18. Girgis, F.G., J.L. Marshall, and A.R.S. Al Monajem. The cruciate ligaments of the knee joint: Anatomical, functional and experimental analysis. Clin. Orthop. 106:216-231, 1975.
19. Gollehon, D.L., P.A. Torzilli, and R.F. Warren. The role of the posterolateral and cruciate ligaments in the stability of the human knee. J. Bone Joint Surg. Am. 69A:233-242, 1987.
20. Grood, E.S., M.S. Hefzy, and T.N. Lindenfield. Factors affecting the region of most isometric femoral attachments. Part 1. The posterior cruciate ligament. Am. J. Sports Med. 20:351-355, 1989.
21. Grood, E.S., S.F. Stowers, and F.R. Noyes. Limits of movement in the human knee: The effects of sectioning the PCL and posterolateral structures. J. Bone Joint Surg. Am. 70A:88-97, 1988.
22. Harner, C.D., G.H. Baek, T.M. Vogrin, G.J. Carlin, S. Kashiwaguchi, and SL-Y. Woo. Quantitative analysis of human cruciate ligament insertions. J. Arthroscopy, in press.
23. Harner, C.D., and J. Höher. Evaluation and treatment of posterior cruciate ligament injuries. Am. J. Sports Med. 26:471-482, 1998.
24. Harner, C.D., J. Höher, T.M. Vogrin, G.J. Carlin, and S.L. Woo. The effects of a popliteus muscle load on in situ forces in the posterior cruciate ligament and on knee kinematics. A human cadaveric study. Am. J. Sports Med. 26:669-673, 1998.
25. Harner, C.D., M.A. Janaushek, A. Kanamori, C.B. Ma, T.M. Vogrin, and SL-Y. Woo. Effects of knee flexion angle and tibial position at the time of graft fixation on the biomechanics of a PCL reconstruction. Trans. ORS 24:23, 1999.
26. Harner, C.D., M.A. Janaushek, A. Kanamori, M. Yagi, T.M. Vogrin, and SL-Y. Woo. Biomechanical analysis of a double bundle posterior cruciate ligament reconstruction. In 25th Annual Meeting of the American Orthopaedic Society for Sports Medicine. Manuscript submitted for publication.
27. Harner, C.D., G.A. Livesay, S. Kashiwaguchi, H. Fujie, N.Y. Choi, and SL-Y. Woo. Comparative study of the size and shape of human anterior and posterior cruciate liga-ments. J. Orthop. Res. 13:429-434, 1995.
28. Harner, C.D., T.M. Vogrin, J. Höher, A. Aroen, G.J. Carlin, and SL-Y. Woo. Injury to the posterolateral structures has profound effects on the function of the human posterior cruciate ligament. Trans. ORS 23:47, 1998.
29. Harner, C.D., J.W. Xerogeanes, G.A. Livesay, G.J. Carlin, B.A. Smith, T. Kusayama, S. Kashiwaguchi, and SL-Y. Woo. The human posterior cruciate ligament complex: An interdisciplinary study - Ligament morphology and biomechanical evaluation. Am. J. Sports Med. 23:736-745, 1995.
30. Heller, L., and J. Langman. The menisco-femoral ligaments of the human knee. J. Bone Joint Surg. Br. 468:307-313, 1964.
31. Höher, J., C.D. Harner, T.M. Vogrin, A. Aroen, and SL-Y. Woo. Hamstring loading increases in situ forces in the PCL. Trans. ORS 23:48, 1988.
32. Holden, J.P., E.S. Grood, D.L. Korvick, J.F. Cummings, D.L. Butler, and D.I. Bylski-Austrow. In vivo forces in the anterior cruciate ligament: Direct measurements during walking and trotting in a quadruped. J. Biomech. 27:517-526, 1994.
33. Hughston, J.C., and T.C. Degenhardt. Reconstruction of the posterior cruciate ligament. Clin. Orthop. 164:59-77, 1982.
34. Insall, J.N., and R.W. Hood. Bone-block transfer of the medial head of the gastrocnemius for posterior cruciate insufficiency. J. Bone Joint Surg. Am. 64A:691-699, 1982.
35. Jakob, R.P., and J.C. Edwards. Posterior cruciate ligament reconstruction: Anterior-posterior two stage technique. Sports Med. Arthro. Rev. 2:137-145, 1994.
36. Keller, P.M., K.D. Shelbourne, J.R. McCarroll, and A.C. Rettig. Nonoperatively treated isolated posterior cruciate ligament injuries. Am. J. Sports Med. 21:132-136, 1993.
37. Kennedy, J.C., and R.D. Galpin. The use of the medial head of the gastrocnemius muscle in the posterior cruciate-deficient knee. Am. J. Sports Med. 10:63-74, 1982.
38. Kennedy, J.C., and R.W. Grainger. The posterior cruciate ligament. J. Trauma 7:367-377, 1967.
39. Kusayama, T., C.D. Harner, G.J. Carlin, W. Xerogeanes, and B.A. Smith. Anatomical and biomechanical characteristics of the human meniscofemoral ligaments. Knee Surg. Sports Traumatol. Arthrosc. 2:234-237, 1994.
40. Lewis, J.L., W.D. Lew, and J. Schmidt. A note on the application and evaluation of the buckle transducer for knee ligament force measurement. J. Biomech. Eng. 104:125-128, 1982.
41. Lipscomb, A.B., Jr., A.F. Anderson, E.D. Norwig, W.D. Hovis, and D.L. Brown. Isolated posterior cruciate ligament reconstruction. Long-term results. Am. J. Sports Med. 21:490-496, 1993.
42. Markolf, K.L., J.R. Slauterbeck, K.L. Armstrong, M.S. Shapiro, and G.A. Finerman. A biomechanical study of replacement of the posterior cruciate ligament with a graft. Part II: Forces in the graft compared with forces in the intact ligament. J. Bone Joint Surg. Am. 79A:375-380, 1997.
43. Markolf, K.L., J.R. Slauterbeck, K.L. Armstrong, M.S. Shapiro, and G.A. Finerman. Effects of combined knee loadings on posterior cruciate ligament force generation. J. Bone Joint Surg. Am. 14A:633-638, 1996.
44. Markolf, K.L., D.C. Wascher, and G.A.M. Finerman. Direct in vitro measurement of forces in cruciate ligaments. Part H: The effect of section of the posterolateral structures. J. Bone Joint Surg. Am. 75A:387-394, 1993.
45. Miller, M.D., C.D. Harner, and S. Kashiwaguchi. Acute posterior cruciate ligament injuries. In Knee Surgery, F.H. Fu, C.D. Harner, and K.G. Vince (Eds.). Baltimore: Williams & Wilkins, 1994, pp. 749-768.
46. Morgan, C.D., V.R. Kalman, and D.M. Grawl. The anatomic origin of the posterior cruciate ligament: Where is it? Reference landmarks for PCL reconstruction. Arthroscopy 13:325-331, 1997.
47. Noyes, F.R., and B. Barber-Westin. Treatment of complex injuries involving the posterior cruciate and posterolateral ligaments of the knee. Am. J. Knee Surg. 9:200-214, 1996.
48. Ogata, K., and J.A. McCarthy. Measurements of length and tension patterns during reconstruction of the posterior cruciate ligament. Am. J. Sports Med. 20:351-355, 1992.
49. Parolie, J.M., and J.A. Bergfeld. Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete. Am. J. Sports Med. 14:35-38, 1986.
50. Petermann, J., L. Gotzen, and P. Trus. Posterior cruciate ligament (PCL) reconstruction - An in vitro study of isometry. Part II. Tests using an experimental PCL graft model. Knee Surg. Sports Traumatol. Arthrosc. 2:104-106, 1994.
51. Petrie, R.S., and C.D. Harner. Double bundle PCL reconstruction technique: University of Pittsburgh approach. Op. Tech. Sports Med. 7(3):93-103, 1999.
52. Poynton, A.R., S.M. Javadpour, P.J. Finegan, and M. O'Brien. The meniscofemoral ligaments of the knee. J. Bone Joint Surg. Br. 79:327-330, 1997.
53. Prietto, M.P., J.R. Bain, S.N. Stonebrook, and R.A. Settlage. Tensile strength of the human posterior cruciate ligament (PCL). Trans. ORS 13:195, 1988.
54. Race, A., and A.A. Amis. The mechanical properties of the two bundles of the human posterior cruciate ligament. J. Biomech. 27:13-24, 1994.
55. Race, A., and A.A. Amis. PCL reconstruction: In vitro biomechanical evaluation of isometric versus single and double bundled anatomic grafts. J. Bone Joint Surg. Br. 808:173-179, 1998.
56. Rudy, T.W., G.A. Livesay, SL-Y. Woo, and F.H. Fu. A combined robotic/universal force sensor approach to determine in situ forces of knee ligaments. J. Biomech. 29:1357-1360, 1996.
57. Seebacher, J.R., A.E. Inglis, J.L. Marshall, and R.F. Warren. The structure of the posterolateral aspect of the knee. J. Bone Joint Surg. Am. 64A:536-541, 1982.
58. Shelbourne, K.D., T.J. Davis, and D.V. Patel. The natural history of acute, isolated nonoperatively treated posterior cruciate ligament injuries: A prospective study. Am. J. Sports Med. 27:276-283, 1999.
59. Sidles, J.A., R.V. Larson, J.L. Garbini, D.J. Downey, and F.A. Matsen III. Ligament length relationships hi the moving knee. J. Orthop. Res. 6:593-610, 1988.
60. Skyhar, M., R. Warren, G. Ortiz, E. Schwartz, and J. Otis. The effects of sectioning of the posterior cruciate ligament and the posterolateral complex on the articular contact pressures within the knee. J. Bone Joint Surg. Am. 75A:694-699, 1993.
61. Southmayd, W.W., and B.D. Rubin. Reconstruction of the posterior cruciate ligament using the semimembranosus tendon. Clin. Orthop. 150:196-197, 1980.
62. Stäubli, H.U. Posteromedial and posterolateral capsular injuries associated with posterior cruciate ligament insufficiency. Sports Med. Arthro. Rev. 2:146-164, 1994.
63. Stäubli, H.U., and R.P. Jakob. Posterior instability of the knee near extension. A clinical and stressradiographic analysis of acute injuries of the posterior cruciate ligament. J. Bone Joint Surg. Br. 72B:225-230, 1990.
64. Stone, J.D., G.J. Carlin, Y. Ishibashi, and C.D. Harner. Assessment of PCL graft performance using robotics technology. Am. J. Sports Med. 24:824-828, 1996.
65. Swenson, T.M., C.D. Harner, and F.H. Fu. Arthroscopic posterior cruciate ligament reconstruction with allograft. Sports Med. Arthro. Rev. 2:120-128, 1994.
66. Terry, G.C., and R.F. LaPrade. The posterolateral aspect of the knee. Anatomy and surgical approach. Am. J. Sports Med. 24:732-739, 1996.
67. Veltri, D.M., X-H. Deng, P.A. Torzilli, R.F. Warren, and M.J. Maynard. The role of the cruciate and posterolateral ligaments in the stability of the knee. Am. J. Sports Med. 23:436-443, 1995.
68. Veltri, D.M., and R.F. Warren. Operative treatment of posterolateral instability of the knee. Clin. Sports Med. 13:615-627, 1994.
69. Vogrin, T.M., J. Höher, C.B. Ma, M.A. Janaushek, SL-Y. Woo, and C.D. Harner. Deficiency of the posterolateral structures as a potential cause of PCL graft failure. Trans. ORS 24:930, 1999.
70. Warren, R.F., and D.F. Veltri. Arthroscopically assisted posterior cruciate ligament reconstruction. Op. Tech. Sports Med. 1:136-142, 1993.
71. Watanabe, Y., H. Moriya, K. Takahashi, M. Yamagata, M. Sonoda, Y. Shimada, and T. Tamaki. Functional anatomy of the posterolateral structures of the knee. J. Arthro. Rel. Surg. 9:57-62, 1993.