Anatomical and biomechanical considerations of the PCL

This article discusses the anatomy and biomechanics of the posterior crucia te ligament (PCL) and PCL reconstructions and their implications for clinic al management of PCL injuries. The PCL consists of two functional component s, the anterolateral and posteromedial, based on their reciprocal tensionin g patterns. The anterolateral has been the focus of single-bundle PCL recon structions. Recent biomechanical studies have indicated that the posteromed ial bundle also plays an important role, and double-bundle PCL reconstructi ons have also been proposed. The PCL works closely with the posterolateral structures in providing posterior knee stability. The effects of several su rgical variables, including graft fixation, associated injuries, and tunnel placement, that can significantly affect the outcome of PCL reconstruction are discussed. With improved knowledge of the PCL, new reconstructive tech niques are being developed, offering the potential of more closely replicat ing the anatomy and biomechanics of the normal PCL and improving clinical o utcomes of PCL injuries.