Systematic review of cadaveric studies on anatomic posterior cruciate ligament reconstruction: the landmarks in anatomic posterior cruciate ligament reconstruction

Abstract

Recently, several new techniques for anatomic posterior cruciate ligament reconstruction (PCLR) have emerged and are believed to restore the normal anatomy of the posterior cruciate ligament more accurately. Despite the latest trend, the optimal methods for anatomic PCLR remain controversial. The purpose of this research is to review surgical techniques for PCLR in cadaver studies and suggest consistent and reproducible technical criteria. For the review of the literature, MEDLINE and EMBASE were screened for articles on anatomic PCLR. Only basic science studies on PCLR performed on human cadavers and written in English were included. Seventeen studies were included in this systematic review. Only the tunnel positions, graft types, and surgical techniques were reported in the majority of the studies. There were many variations of the reported tunnel positions, graft types, and surgical techniques among the studies. In most studies, surgical techniques for consistent and reproducible anatomic PCLR were not explained clearly. Therefore, high level medical research should be encouraged in order to establish standard surgical techniques for anatomic PCLR.

Keywords: Cadaveric study; Posterior cruciate ligament; Reconstruction.

Fig. 1

Flow diagram for systematic review of the literature.

Fig. 2

Femoral footprint of the posterior cruciate ligament (imaging was reconstructed using Geomagic Software). (A) a: AL bundle, b: PM bundle, c: medial bifurcate ridge, d: medial intercondylar notch. (B) Femoral footprint at three-dimensional reconstructed imaging. AL: anterolateral, PM: posteromedial.

Fig. 3

Tibial footprint of posterior cruciate ligament (imaging was reconstructed using Geomagic Software). (A) a: AL bundle, b: PM bundle, c: posterior edge of shelf. (B) Tibial footprint at three-dimensional reconstructed imaging. AL: anterolateral, PM: posteromedial.