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Posterior Cruciate Ligament Injury: Multimedia
Updated: Dec 22, 2006
Multimedia
 | Media file 1: A normal lateral radiograph of a knee. In a normal knee, a line drawn along the posterior femoral condyle will not intersect the posterior tibial condyle. |
 | Media file 2: A lateral radiograph of a knee with a posterior cruciate ligament injury. Note that the same line as in Image 1 will bisect the posterior tibial condyle due to a posterior sag and an incompetent posterior cruciate ligament. |
 | Media file 3: The posterior tibia sag sign. The photo on the left demonstrates the clinical finding of the posterior tibia sag sign. A line drawn parallel to the patella accentuates the posterior tibia sag. The photo on the right demonstrates the quadriceps active drawer test described by Daniels. With the knee in 70-90° of flexion, the extensor mechanism is contracted, pulling the tibia anteriorly into a reduced position. |
 | Media file 4: A close-up view of a posterior tibia sag with an incompetent posterior cruciate ligament. |
 | Media file 5: This MRI of the knee shows a torn posterior cruciate ligament. |
 | Media file 6: This MRI (coronal section) shows a posterior cruciate ligament tear. |
 | Media file 7: This transverse MRI shows edema to the torn posterior cruciate ligament. |
 | Media file 8: A view of the broad origin of the posterior cruciate ligament (PCL) on the medial femoral condyle of a left knee. The anterior cruciate ligament has been removed for surgical reconstruction. |
 | Media file 9: An additional view of the posterior cruciate ligament broad origin and insertion in a knee pending anterior cruciate ligament reconstruction. |
 | Media file 10: A right knee pending posterior cruciate ligament (PCL) reconstruction. A minimal notchplasty is completed. Two guide pins are advanced into the medial femoral condyle for tunnel placement to reconstruct the 2 bundles of the PCL. |
 | Media file 11: The 2 tunnels are created by reaming from outside in; 8- to 9-mm tunnels are made depending on patient size and the graft that will be used. |
 | Media file 12: Two red Robinson catheters are advanced through the femoral tunnels. |
 | Media file 13: The catheters have premade holes, which are used for suture retrieval. |
 | Media file 14: The catheters are advanced and threaded out the posterior knee. In this case, a posterior tibial onlay graft from an Achilles tendon allograft is used. The 2 bundles are secured to the catheters and advanced into the joint through the tunnels. |
 | Media file 15: The 2 Achilles tendon bundles are secured with a baseball whipstitch and threaded through the catheter holes and advanced into the femoral condyle tunnels. |
 | Media file 16: Additional view of the placement and advancement of the Achilles allograft. |
 | Media file 17: Completion and seating of the femoral allograft reconstruction. The 2 bundles are secured or stabilized by suturing over a post and washer. Note the reestablishment of the broad surface area for the reconstructed posterior cruciate ligament origin. |
 | Media file 18: Completion of the tibial onlay two bundle Achilles tendon allograft/posterior cruciate ligament (PCL) reconstruction. The bony calcaneus remnant is secured to the posterior tibia with 1 or 2 interfragmentary compression screws into a trough into the posterior tibia at the level of the PCL insertion. Care is taken to not penetrate the anterior tibial cortex with these screws. Note the intact original anterior cruciate ligament. |
More on Posterior Cruciate Ligament Injury |
| Overview: Posterior Cruciate Ligament Injury |
| Differential Diagnoses & Workup: Posterior Cruciate Ligament Injury |
| Treatment & Medication: Posterior Cruciate Ligament Injury |
| Follow-up: Posterior Cruciate Ligament Injury |
 Multimedia: Posterior Cruciate Ligament Injury |
| References |
| « Previous Page |
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Further Reading
Keywords
posterior cruciate ligament, PCL injury, PCL tear, posterior knee instability, posterior laxity of the knee
