THE ANATOMIC ORIGIN OF THE POSTERIOR CRUCIATE LIGAMENT - WHERE IS IT - REFERENCE LANDMARKS FOR PCL RECONSTRUCTION

There is a lack of defined reference points for reproducible femoral t unnel placement during posterior cruciate ligament (PCL) reconstructio n. The PCL, consisting of two major bands, anterolateral (AL) and post eromedial (PM), has a femoral origin that spans 3 cm, which cannot be covered by a substitute graft positioned in one femoral tunnel to reco nstruct the PCL. The purpose of this study was to define the location of the anatomic origin of both bands of the PCL in reference to local anatomy to develope landmarks that can be used to reproducibly positio n two femoral tunnels (one to each band's origin) during PCL reconstru ction. The anatomy of the PCL origin was dissected and studied in 20 k nees at the time of total knee replacement. The central origin point f or each band was marked, and its distance was measured in reference to three axes. The AL band centrally originated 13 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 13 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof inte rface. The PM band centrally originated 8 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 20 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof interface. These distances were noted to be relatively constant despite varying k nee morphologies and size. For this reason, referencing the articular cartilage-intercondylar roof, and wall interfaces may be used as a met hod to facilitate more reproducible anatomic femoral tunnel placement during PCL reconstruction.