2025 ISAKOS Biennial Congress ePoster
The Role Of Fiber Areas In The Tibial Footprint Of The Posterior Cruciate Ligament Changes Depending On Flexion Angle – A Biomechanical Robotic Investigation
Adrian Deichsel, MD, Münster, NRW GERMANY
Thorben Briese, MD, Münster GERMANY
Wenke Liu, MD, Münster, NRW GERMANY
Michael J. Raschke, MD, Prof., Münster GERMANY
Alina Albert, M.Sc., Münster, NRW GERMANY
Christian Peez, MD, Münster, NRW GERMANY
Elmar Herbst, MD, PhD, Muenster GERMANY
Christoph Kittl, MD, MD(res), Muenster GERMANY
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, NRW, GERMANY
FDA Status Not Applicable
Summary
The central fiber areas in the tibial footprint of the PCL were identified to be the main contributors, while, depending on the flexion angle, the more medial or lateral fiber areas were more active.
Abstract
Background
Similar to the anterior cruciate ligament, the tibial footprint of the posterior cruciate ligament (PCL) is composed of different fiber areas, possibly having distinct biomechanical functions.
Purpose
To determine the role of different fiber areas of the tibial footprint of the PCL in restraining posterior tibial translation.
Methods
A sequential cutting study was performed on eight fresh-frozen human knee specimens, utilizing a 6 degrees of freedom robotic test setup. The tibial attachment of the PCL was divided into 9 areas, which were sequentially cut from the bone in a randomized sequence. After determining the native knee kinematics with 89 N anterior, and posterior tibial translation force, from 0 to 90° of flexion, a displacement-controlled protocol was performed replaying the native motion, while constantly measuring the force. Utilizing the principle of superposition, the reduction of the restraining force represents the contribution of each cut fiber area. Statistical analysis was performed utilizing mixed linear models with posthoc Dunn’s correction.
Results
The PCL was found to contribute 25.3 ± 11.1 % in 0° of flexion, 49.7 ± 19.2 % in 30° of flexion, 58.9 ± 19.3 % in 60° of flexion, and 50.6 ± 15.1 % in 90° of flexion. Depending on the flexion angle, every cut quadrant of the tibial PCL footprint was shown to be a significant restrictor of posterior tibial translation (P ≤ 0.05). When investigating the fiber areas from anterior to posterior, the central fiber areas showed the highest contribution (35.0 – 44.3 %). Furthermore, when investigating the fiber areas from medial to lateral, from 0 – 30°, the lateral fiber areas were most active (41.4 – 43.6 %), while in 90° of flexion, the medial fiber areas showed the highest contribution (41.5 %).
Conclusion
All fiber areas in the tibial footprint of the PCL significantly contributed to restriction of a posterior tibial translation force. The central areas were identified to be the main contributors inside the tibial footprint, while, depending on the flexion angle, the more medial or lateral fiber areas were more active.