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Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study

Background: Recent evidence has highlighted a risk that the majority of posterior cruciate ligament (PCL) is removed while making bone cuts in tibia and femur during total knee replacement surgery. Aim of this cadaveric study is to calculate how much PCL footprint is retained in a PCL retaining pros...

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Autores principales: Goyal, Tarun, Singla, Mukesh, Paul, Souvik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134878/
https://www.ncbi.nlm.nih.gov/pubmed/30207266
http://dx.doi.org/10.1051/sicotj/2018013
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author Goyal, Tarun
Singla, Mukesh
Paul, Souvik
author_facet Goyal, Tarun
Singla, Mukesh
Paul, Souvik
author_sort Goyal, Tarun
collection PubMed
description Background: Recent evidence has highlighted a risk that the majority of posterior cruciate ligament (PCL) is removed while making bone cuts in tibia and femur during total knee replacement surgery. Aim of this cadaveric study is to calculate how much PCL footprint is retained in a PCL retaining prosthesis after routine tibial and femoral cuts are made.  Methods: Twelve paired formalin-fixed Indian cadaveric knees were studied. Knees were disarticulated and all soft tissues were circumferentially removed from the tibia and femur. Footprints of antero-lateral and postero-medial bundles were marked on tibia and femur. Proximal tibial and distal femoral cuts were made using standard cutting jigs (Zimmer NexGen LPS). Digital photographs were taken with a magnification marker attached on the bone before and after making the cuts. Area of PCL insertion before and after the bone cuts was measured using software ImageJ (National Institute of Health). Results: Footprint on tibial side was reduced by 9.1%, and on femoral side by 21.8%. Footprint of AL bundle was reduced by 24.3% on the tibial side and by 15.3% on the femoral side. Footprint of PM bundle on tibia was not affected by the bone cut but was reduced by 18.5% on the femoral side. Conclusion: Tibial and femoral insertions of PCL are relatively well preserved after bone cuts are made in a posterior cruciate retaining TKR. There is differential sectioning of antero-lateral and postero-medial bundles of PCL on tibial and femoral sides.
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spelling pubmed-61348782018-09-20 Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study Goyal, Tarun Singla, Mukesh Paul, Souvik SICOT J Original Article Background: Recent evidence has highlighted a risk that the majority of posterior cruciate ligament (PCL) is removed while making bone cuts in tibia and femur during total knee replacement surgery. Aim of this cadaveric study is to calculate how much PCL footprint is retained in a PCL retaining prosthesis after routine tibial and femoral cuts are made.  Methods: Twelve paired formalin-fixed Indian cadaveric knees were studied. Knees were disarticulated and all soft tissues were circumferentially removed from the tibia and femur. Footprints of antero-lateral and postero-medial bundles were marked on tibia and femur. Proximal tibial and distal femoral cuts were made using standard cutting jigs (Zimmer NexGen LPS). Digital photographs were taken with a magnification marker attached on the bone before and after making the cuts. Area of PCL insertion before and after the bone cuts was measured using software ImageJ (National Institute of Health). Results: Footprint on tibial side was reduced by 9.1%, and on femoral side by 21.8%. Footprint of AL bundle was reduced by 24.3% on the tibial side and by 15.3% on the femoral side. Footprint of PM bundle on tibia was not affected by the bone cut but was reduced by 18.5% on the femoral side. Conclusion: Tibial and femoral insertions of PCL are relatively well preserved after bone cuts are made in a posterior cruciate retaining TKR. There is differential sectioning of antero-lateral and postero-medial bundles of PCL on tibial and femoral sides. EDP Sciences 2018-09-12 /pmc/articles/PMC6134878/ /pubmed/30207266 http://dx.doi.org/10.1051/sicotj/2018013 Text en © The Authors, published by EDP Sciences, 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Goyal, Tarun
Singla, Mukesh
Paul, Souvik
Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title_full Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title_fullStr Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title_full_unstemmed Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title_short Anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
title_sort anatomy of posterior cruciate ligament retained in a posterior cruciate ligament retaining total knee replacement: a cadaveric study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134878/
https://www.ncbi.nlm.nih.gov/pubmed/30207266
http://dx.doi.org/10.1051/sicotj/2018013
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