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An Analysis of the Posterior Cruciate Ligament Isometric Position Using an In Vivo 3-Dimensional Computed Tomography–Based Knee Joint Model

2010; Elsevier BV; Volume: 26; Issue: 10 Linguagem: Inglês

10.1016/j.arthro.2010.02.016

1526-3231

Woon-Seob Jeong, Yon-Sik Yoo, Do-Young Kim, Nagraj S. Shetty, Patrick Smolinski, Kartik Logishetty, Anil S. Ranawat,

Lower Extremity Biomechanics and Pathologies

Purpose This study aimed to review the isometric point of the posterior cruciate ligament (PCL) based on insertional locations identified in recent anatomic studies by use of a 3-dimensional knee model. Methods Ten living subjects with healthy knees were evaluated. High-resolution computed tomography scans were performed at 3 positions of 0°, 90°, and 135°, and 3-dimensional knee images were constructed. Customized software was used to define tibial and femoral insertion points of the PCL, based on recently described anatomy. The femoral attachment site of the PCL was divided into 4 sectors (labeled A through D), and the tibial attachment site was divided into 6 sectors (labeled 1 through 6). Twenty-four virtual PCL bundles were created between these sectors, and their length was measured in the 3 knee flexion positions. Results In 0° and 90° of knee flexion, the virtual bundle showing the least amount of length change (1.10 ± 0.66 mm) was at sector D-6, that is, a posteromedial bundle inserting into the most posterior femoral sector (sector D) and the most distal tibial sector (sector 6). This change was not significantly different compared with all other virtual bundles with tibial points connected to femoral sector D (P > .05). An isometric position for the PCL (length change .05). An isometric position for the PCL (length change <2 mm) could not be found in 135° of knee flexion because of lengthening of all virtual bundles. Our data suggest that the femoral attachment point is more important than the tibial attachment point: any of the 6 tibial bundles attached to the most posterior femoral sector had similar isometric properties.