Reconstruction of the posterior cruciate ligament using a new drill-guide.

In 40 normal cadaver knees from adults (mean age 29 years) the average length of the posterior cruciate ligament was 38 +/- 4 mm. The angle between the ligament and the long axis of the femur was 43.4 +/- 3 degrees with the knee in full extension. We studied the functional importance of different attachments of the posterior cruciate ligament. The distance between the central point of the normal attachment area on the tibia and the central proximal part of the femoral attachment area on the medial femoral condyle was found to change least during full range of knee motion. On the basis of the results in the present study we suggest some basic principles for a standardized replacement operation for a deficient posterior cruciate ligament using a new drill-guide. The drill-guide has been used in 14 consecutive patients (mean age 26 +/- 6 years) who underwent a reconstruction of the posterior cruciate ligament. The patients have been followed for 2 years. The Lysholm score increased significantly from 60 +/- 16 preoperatively to 76 +/- 15 (P < 0.001) at 2 years, and the stability, measured with a laxity tester, improved from 8 +/- 3 mm total excursion preoperatively to 6 +/- 3 mm at 2 years follow-up. The follow-up time is still short but the results seem to be promising.