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,
,*
From the Orthopaedic Biomechanics Laboratory, Massachusetts General Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts.
* Address correspondence and reprint requests to Guoan Li, PhD, Bioengineering Laboratory, 55 Fruit St, GRJ 1215, Boston, MA 02114.
Background: The mechanism of cartilage degeneration in the patellofemoral joint (PFJ) and medial compartment of the knee following posterior cruciate ligament (PCL) injury remains unclear. PCL reconstruction has been recommended to restore kinematics and prevent long-term degeneration. The effect of current reconstruction techniques on PFJ contact pressures is unknown.
Purpose: To measure PFJ contact pressures after PCL deficiency and reconstruction.
Method: Eight cadaveric knees were tested with the PCL intact, deficient, and reconstructed. Contact pressures were measured at 30°, 60°, 90°, and 120° of flexion under simulated muscle loads. Knee kinematics were measured by a robotic testing system, and the PFJ contact pressures were measured using a thin film transducer. A single bundle achilles tendon allograft was used in the reconstruction.
Results: PCL deficiency significantly increased the peak contact pressures measured in the PFJ relative to the intact knee under both an isolated quadriceps load of 400 N and a combined quadriceps/hamstrings load of 400 N/200 N. Reconstruction did not significantly reduce the increased contact pressures observed in the PCL-deficient knee.
Conclusion: The elevated contact pressures observed in the PCL-deficient knee and reconstructed knee might contribute to the long-term degeneration observed in both the non-operatively treated and PCL-reconstructed knees.
Key Words: posterior cruciate ligament • patellofemoral joint • contact pressures • ligament reconstruction • knee biomechanics
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