Radiographic assessment of the femoral insertion of the posterior cruciate ligament

OBJECTIVE: To establish the radiographic images of the femoral insertion of the posterior cruciate ligament (PCL), in order to assist the creation of anatomical femoral tunnels during surgeries, and to be used as parameters in postoperative evaluation of the location of these tunnels. METHODS: Thirty adult cadaver knees were used. The PCL anterolateral (AL) and posteromedial (PM) bundles' center was marked with a metallic marker. Radiographs were taken and a grid system was established to locate the position of bundles insertion. The percentile in which the projection of each bundle's center was in relation to the Blumensaat line was also determined. RESULTS: In the anteroposterior view, AL and PM bundles' centers were on average, on the 42.5% and 38.18% percentiles of Blumensaat's line, respectively. In lateral views, the AL and PM bundles' centers corresponded to the 72.94% and 55.56% percentiles of the line, respectively. In 73.33% of the knees the AL bundle center was on the 3D quadrant and in 70% of samples the PM bundle center was in quadrant 2D. CONCLUSIONS: We established an X-ray pattern of femoral insertion of PCL that may be of interest for intraoperative control, before tunnel drilling, and also for post-operative evaluation of tunnel location. Controlled Laboratory Study.