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Biomechanical verification that PCL reconstruction is unnecessary in the muscle-stabilized knee
Journal article   Peer reviewed

Biomechanical verification that PCL reconstruction is unnecessary in the muscle-stabilized knee

David H Sohn, Sriram Balasubramanian, Constantine Demetropoulos, King Yang, Joseph Guettler and Kenneth A Jurist
Orthopedics (Thorofare, N.J.), v 33(5)
12 May 2010
DOI: https://doi.org/10.3928/01477447-20100329-12
PMID: 20506950

Abstract

Biomechanical Phenomena Knee Joint - physiology Posterior Cruciate Ligament - injuries Humans Quadriceps Muscle - physiology Unnecessary Procedures Posterior Cruciate Ligament - physiology
Treatment of isolated posterior cruciate ligament (PCL) injuries is controversial. This is due in part to the discrepancy between clinical and biomechanical studies in the literature. Clinically, isolated PCL injuries are treated nonoperatively, and patients do well as long as they have adequate quadriceps function. Biomechanically, however, PCL injuries have been shown in cadavers to lead to altered kinematics and increased contact pressures. These studies, however, did not simulate weight-bearing muscle forces, which can compensate for the PCL deficiency. We sought to study the biomechanical effects of PCL deficiency and reconstruction in a cadaveric knee, but with reproduction of the muscle-stabilizing effects of the quadriceps and hamstring muscles. We used a novel 6 degrees of freedom testing system to simulate a muscle-stabilized cadaveric knee and recorded both kinematics and contact pressure data. Four conditions were tested: normal, PCL-deficient, and PCL single- and double-bundle reconstructed states. We found that with muscle stabilization, there were no significant changes in kinematics or contact pressures in the knee between any of these conditions. This corroborates clinical findings and verifies that PCL reconstruction is unnecessary in the muscle-stabilized knee.

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