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The American Journal of Sports Medicine 30:643-651 (2002)
© 2002 American Orthopaedic Society for Sports Medicine

Posterior Cruciate Ligament Femoral Insertion Site Characteristics

Importance for Reconstructive Procedures

Etienne A. Mejia, MD, Frank R. Noyes, MD* and Edward S. Grood, PhD

From the Cincinnati Sportsmedicine and Orthopaedic Center and the Noyes Biomechanics Laboratories, Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio

* Address correspondence and reprint requests to Frank R. Noyes, MD, Cincinnati Sportsmedicine and Orthopaedic Center, 311 Straight Street, Cincinnati, OH 45219

Background: Previous descriptions of the insertion site of the posterior cruciate ligament are inadequate.

Hypothesis: More than one reference system is required to adequately represent the anatomy of the femoral attachment.

Study Design: Descriptive anatomic study.

Methods: Twelve cadaveric specimens were evaluated by using two measurement methods relative to the femoral articular cartilage margin and two methods relative to the intercondylar femoral roof.

Results: Reference lines perpendicular to the articular cartilage best defined the 12- and 1-o’clock positions, and those perpendicular to the articular cartilage or parallel to the femoral shaft best defined the 2-, 3-, and 4-o’clock positions. The angle of the proximal attachment to the roof was 88° ± 5.5°. The posterior cruciate ligament was a continuum of fibers rather than two distinct bundles, and its attachment showed variability in shape and thickness, extending past the midline in the notch (11:21 ± 15 minutes to 4:12 ± 20 minutes, right knee).

Conclusions: More than one measurement system is required to accurately describe the femoral origin of the posterior cruciate ligament.

Clinical Relevance: Accurate assessment of the anatomy is crucial for successful surgical reconstruction of the posterior cruciate ligament femoral attachment.




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