Anatomy of the femoral footprint of the posterior cruciate ligament: a systematic review.

Purpose: The purpose of this study was to summarize the past 10 years of orthopaedic literature to better delineate the femoral origin of the posterior cruciate ligament (PCL).

Methods: A PubMed search was conducted by 2 independent reviewers (M.P., M.V.) using the search terms "posterior cruciate ligament" or "PCL," "femur" or "femoral," and "anatomy" or "origin" or "footprint." Cadaveric and radiographic studies performed between January 1, 2003, and November 30, 2013, were analyzed.

Results: Aggregate data from radiographic parameters indicate that the anatomic origin of the anterolateral bundle lies 40% of the distance from the anterior articular surface of the femur and 14.5% of the tangent distance from the Blumensaat line toward the intercondylar notch. The origin of the posteromedial bundle lies 56% from the anterior surface and 36.5% of the tangent distance toward the notch. On the basis of cadaveric data, the center of the anterolateral bundle is 8 mm from the anterior surface (27.5% of the Blumensaat line), 4.7 mm tangent from the Blumensaat line toward the notch (22.5% of the tangent distance), and 3.6 mm from the medial intercondylar ridge; the center of the posteromedial bundle is 11.9 mm from the anterior articular surface (42.5%), 10.9 mm along the tangent line (57.5%), and 3.1 mm from the medial intercondylar ridge.

Conclusions: We were able to precisely delineate the femoral origin of the PCL through our systematic review.

Clinical Relevance: Our systematic review may assist arthroscopic knee surgeons in placing anatomic tunnels during reconstruction of the PCL.