Posterior cruciate ligament femoral insertion site characteristics. Importance for reconstructive procedures.

Abstract

Previous descriptions of the insertion site of the posterior cruciate ligament are inadequate. More than one reference system is required to adequately represent the anatomy of the femoral attachment. Descriptive anatomic study. 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. 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 degrees +/- 5.5 degrees. 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). More than one measurement system is required to accurately describe the femoral origin of the posterior cruciate ligament. Accurate assessment of the anatomy is crucial for successful surgical reconstruction of the posterior cruciate ligament femoral attachment.