Purpose
Posterior cruciate ligament (PCL) injuries are often associated with injuries of the
posteromedial structures of the knee. The motivation for this study was the attempt
to test different reconstruction techniques for the structures of the posteromedial
corner in a biomechanical experiment.
Methods
Kinematic studies were carried out on 10 cadaveric knees exposed to a 134-N posterior
tibial load, 10-Nm valgus torque, and 5-Nm internal torque at 0°, 30°, 60°, and 90°
of flexion. The resulting posterior tibial translation (PTT) was determined using
a robotic/universal force-moment sensor testing system for (1) intact knees, (2) PCL-deficient
knees, (3) knees with deficiency of the PCL and the posteromedial structures, (4)
knees with only the PCL reconstructed, (5) knees with the PCL and posterior oblique
ligament (POL) reconstructed, and (6) knees with the PCL, medial collateral ligament
(MCL), and POL reconstructed. Kinematic data were analyzed by a 2-factor repeated
analysis of variance.
Results
When both the PCL and the posteromedial structures were cut, PTT increased significantly
at all flexion grades under a posterior tibial load (P < .05). Reconstruction of only the PCL could not restore PTT at 0°, 30°, 60°, and
90° of flexion under loading conditions in a knee with combined injury of the PCL
and the posteromedial structures (P > .05). Additional reconstruction of the POL improved PTT at all flexion angles in
comparison with only the PCL-reconstructed knee. Reconstruction of the MCL had no
significant effect on PTT.
Conclusions
This study shows that reconstruction of the POL contributes significantly to the normalization
of coupled PTT in knees with combined injury of the PCL and the posteromedial structures
under valgus or internal rotational moment. The supplementary reconstruction of the
MCL did not provide significant improvement in knee kinematics.
Clinical Relevance
The POL should be addressed in the patient with combined injuries of the PCL and the
posteromedial structures.
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Article info
Publication history
Published online: April 30, 2012
Accepted:
February 2,
2012
Received:
December 9,
2010
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
