Morphometric analysis of posterior cruciate ligament: an Indian cadaveric study

Background: Functionally, the posterior cruciate ligament (PCL) is divided into an anterolateral (AL) and a posteromedial (PM) bundle. Bundle-level morphometric data are needed to guide anatomically accurate PCL reconstruction. Methods: The AL and PM bundles of the PCL were dissected and measured in 30 adult Indian cadaveric knees. Measurements of bundle length, midpoint width, and femoral and tibial attachment areas were recorded at knee flexion angles of 30°, 60°, and 90°. Results: The AL bundle length increased from 34.5 mm at 30° flexion to 38.5 mm at 90° flexion, while its midpoint width decreased from 6.23 mm to 5.92 mm. In contrast, the PM bundle length decreased from 32.82 mm to 30.79 mm, whereas its midpoint width increased from 4.14 mm to 4.32 mm across the same range of flexion. Both bundles demonstrated larger femoral attachment areas compared to their corresponding tibial attachment areas. These findings indicate significant flexion-dependent changes in PCL bundle morphology. Conclusions: Knee flexion produced significant, reciprocal changes in the dimensions of the two PCL bundles. These values provide population-specific anatomical reference data that may assist the planning of anatomical PCL reconstruction in Indian patients; their clinical relevance requires confirmation.