2025 ISAKOS Biennial Congress ePoster
A Specific Area In The Femoral Footprint Of The Posterior Cruciate Ligament Acts As A Major Contributor In Resisting Posterior Tibial Displacement – A Biomechanical Robotic Investigation
Adrian Deichsel, MD, Münster, NRW GERMANY
Thorben Briese, MD, Münster GERMANY
Wenke Liu, MD, Münster, NRW GERMANY
Michael J. Raschke, MD, Prof., Münster GERMANY
Alina Albert, M.Sc., Münster, NRW GERMANY
Christian Peez, MD, Münster, NRW GERMANY
Elmar Herbst, MD, PhD, Muenster GERMANY
Christoph Kittl, MD, MD(res), Muenster GERMANY
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, NRW, GERMANY
FDA Status Not Applicable
Summary
An area towards the proximal and posterior part of the femoral PCL footprint, directly adjacent to the medial intercondylar ridge, was found to be an important restraint (40-60 %) to a posterior tibial drawer force.
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Abstract
Background
Similar to the anterior cruciate ligament, the femoral footprint of the posterior cruciate ligament (PCL) is composed of different fiber areas, possibly having distinct biomechanical functions.
Purpose
The purpose of this study was to determine the role of different fiber areas of the femoral footprint of the PCL in resisting posterior tibial translation (PTT).
Methods
A sequential cutting study was performed on eight fresh-frozen human knee specimens, utilizing a 6 degrees of freedom robotic test setup. After determining the native knee kinematics (89 N anterior tibial translation / PTT) in 0 – 90° of flexion, a position-controlled protocol was performed replaying the native displacements, while measuring the force. The percentage reduction of force was measured after each cut, by utilizing the principle of superposition. The femoral attachment of the PCL was divided into 15 areas. These fiber areas were sequentially resected from the bone in a randomized order. Statistical analysis was performed with PRISM (GraphPad Software) utilizing mixed linear models, with posthoc Dunnett-Correction, to determine the fiber areas with the highest contribution to restricting a PTT.
Results
The PCL was found to contribute 29 ± 16 % in knee extension, 51 ± 24 % in 30° of flexion, 60 ± 22 % in 60° of flexion, and 55 ± 18 % in 90° of flexion. Statistical evaluation revealed that all significant contributors (4 out of 15 fiber areas) to restraining a PTT were located directly adjacent to the medial intercondylar ridge, in the proximal and posterior aspect of the femoral PCL footprint. Together, these four areas (ca. 20x5 mm in size) contributed over 60 % to the ability of the PCL to restraining a PTT.
Conclusion
An area towards the proximal and posterior part of the femoral PCL footprint, directly adjacent to the medial intercondylar ridge, was found to be the main restraint to a posterior tibial drawer force. A PCL reconstruction in this area may be advantageous to restore the native knee kinematics.