Information about a piece of news titled New knowledge about surgery techniques and function of the posterior cruciate ligament
New knowledge about surgery techniques and function of the posterior cruciate ligament
Intoduction
Two recently published articles in the American Journal of Sports Medicine by researchers from the Oslo Sports Trauma Research Center and the renowned group of Professor Rob LaPrade in Vail, confirm the stabilizing role of the posterior cruciate ligament (PCL) in deep knee flexion and serve as a foundation for re-creating the native knee kinematics with a PCL reconstruction.
The posterior cruciate ligament (PCL) is the knee´s strongest ligament and important for the stabilization of the knee joint during knee flexion. The PCL can restrain a much higher load than the anterior cruciate (ACL) ligament.
Patients with an isolated PCL injury are seldom reconstructed and are considered to be relatively well functioning.
However, recent research has revealed that these patients suffer from poor knee function.
Other studies have identified an early development of knee osteoarthritis in patients with non-operated isolated PCL injuries.
Understand native knee kinematics and the role of the PCL
A joint project between the Oslo Sports Trauma Research and the Steadman Philippon Research Institute in Vail, Colorado, aimed to investigate the stabilizing role of the 2 PCL bundles (anterolateral and posteromedial bundles) for normal knee kinematics.
A better understanding of the functional role of the PCL will provide important information both for patients with conservative treatment and for the improvement of surgery techniques for this population. Also, new insight will help clinicians and researchers to develop and optimize knee orthosis for this type of injury.
Both bundles important for knee stabilization
Cadaver studies of 20 knees showed that both the anterolateral and posteromedial bundles play an important role in resisting posterior tibial translation at all knee flexion angles.
The stabilizing role of the 2 bundles was considerably present in deep knee flexion (below 90°), which is important for many sports such as snowboarding.
Download the article in AJSM (Part 1).
Another cadaver study intended to look at various surgical techniques following a PCL injury. As shown recently in a project by staff at the Oslo Sports Trauma Research Center (Asbjørn Årøen, picture), patients with an isolated PCL injury suffer from poor knee function and do not seem prioritized for surgery.
New and improved surgical techniques are therefore required to relieve the burden.
“Double bundle technique” superior “single-bundle”
The current study demonstrated that a reconstruction of the PCL with a "double bundle" technique is superior to a "single bundle" technique.
The benefit is most pertinent for resistance to posterior translation across a full range of flexion and rotational stability beyond 90° of knee flexion.
If these findings can be successfully reproduced in a clinical patient study, the results will significantly impact patients with this knee injury that requires PCL reconstruction surgery.