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The meniscofemoral ligaments: secondary restraints to the posterior drawer

ANALYSIS OF ANTEROPOSTERIOR AND ROTARY LAXITY IN THE INTACT AND POSTERIOR-CRUCIATE-DEFICIENT KNEE

Departments of Mechanical Engineering and Bioengineering and Musculoskeletal Surgery

A. M. J. Bull, PhD, Lecturer

Department of Bioengineering

R. D. Thomas, FRCS Ed (Orth), Consultant Orthopaedic Surgeon

Department of Musculoskeletal Surgery

A. A. Amis, DSc, Professor of Orthopaedic Biomechanics

Departments of Mechanical Engineering and Musculoskeletal Surgery, Imperial College, Exhibition Road, London SW7 2BX, UK.

Correspondence should be sent to Dr C. M. Gupte.

We have tested the hypothesis that the meniscofemoral ligaments make a significant contribution to resisting anteroposterior and rotatory laxity of the posterior-cruciate-ligament-deficient knee. Eight cadaver human knees were tested for anteroposterior and rotatory laxity in a materials-testing machine. The posterior cruciate ligament (PCL) was then divided, followed by division of the meniscofemoral ligaments (MFLs). Laxity results were obtained for intact, PCL-deficient, and PCL-MFL-deficient knees.

Division of the MFLs in the PCL-deficient knee increased posterior laxity between 15° and 90° of flexion. Force-displacement measurements showed that the MFLs contributed 28% to the total force resisting posterior drawer at 90° of flexion in the intact knee, and 70.1% in the PCL-deficient knee. There was no effect on rotatory laxity.

This is the first study which shows a function for the MFLs as secondary restraints to posterior tibial translation. The integrity of these structures should be assessed during both imaging and arthroscopic studies of PCL-injured knees since this may affect the diagnosis and management of such injuries.