✅ Knee MRI Mastery/Chap 2.ACL and PCL

(Fig 2-E.29) Femoral Tunnel Placement of PCL Reconstruction

MSK MRI 2024. 4. 29. 11:07

https://youtu.be/s1cezFjtZaY

https://youtu.be/UgiSgNcqguA

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✅ Posterior Cruciate Ligament (PCL) Reconstruction: Single Bundle Technique

1. Anatomy of the PCL Bundles:

  • The anterolateral bundle arises anteriorly from the lateral margin of the medial femoral condyle and extends up to the roof of the intercondylar notch.
  • The posteromedial bundle attaches slightly more medially and posterior to the anterolateral bundle.

 

2. Single-Bundle Reconstruction Technique:

  • Aims to reconstruct the more prominent anterolateral bundle.
  • Femoral Tunnel Placement:
  • Located in the anterior half of the native PCL insertion site.
  • Near the femoral insertion of the native anterolateral bundle.
  • Typically at the 1 o'clock position for a right knee, or 11 o'clock for a left knee.
  • Approximately 8-10 millimeters from the articular margin.

 

3. Assessing Tunnel Placement:

  • Using a grid system, the insertion of the anterolateral bundle is around:
  • 40% in the shallow-deep direction.
  • 14.5% in the high-low direction.

4. Limitations of Single-Bundle Technique:

  • It does not fully limit posterior displacement of the tibia at 90 degrees of flexion, as the posteromedial bundle is not reconstructed.

 

Skeletal Radiol. 2014 Dec;43(12):1659-68.

Semin Musculoskelet Radiol. 2016 Feb;20(1):43-51

Magn Reson Imaging Clin N Am. 2022 May;30(2):261-275

 

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