Successful reconstruction of the posterior cruciate ligament: assessment of posterior cruciate ligament footprints using an objective coordinate system

Abstract

Introduction Anatomic cruciate ligament reconstruction is known to be correlated with better clinical results. The aim of the study was to provide a simple method to enable anatomic results in the setting of PCL reconstruction. We, therefore, assessed the tibial and femoral insertion site of the posterior cruciate ligament (PCL) by the use of an objective coordinate system in an anatomical study. We also sought to show reproducibility of these measurements using intra- and inter-observer coefficients. Materials and methods We studied 64 knees, previously preserved according to Thiel’s technique. After proper preparation of the articular surfaces of both the tibiae and femora, photographs were taken according to a standardized protocol. PCL footprints were measured by the use of a coordinate system twice by two examiners. We evaluated these measurements by use of the Cohen’s kappa inter- and intra-observer coefficient for two observers. Results Tibial and femoral measurements of PCL footprints were generated with highly comparable inter- ( k = 0.970) and intra-observer ( k = 0.992) coefficients and may, therefore, be considered as highly reproducible. Conclusion Our findings confirmed the reproducibility of defining PCL footprints using a coordinate system and may contribute to planning intraoperative graft-placement to ensure optimal conditions in the upcoming techniques for PCL reconstruction.

Graft position at the femoral condyle affects knee mobility after posterior cruciate ligament replacement

“…Generalization of the results was provided by ensuring a reproducible and well-documented surgical technique with accurate femoral and tibial graft placement. In a recent study generalization of a well-planned and precisely conducted surgical approach was confirmed by good inter-and intra-observer repeatability [21].…”