The Effect of Posterior Cruciate Ligament Reconstruction Operations on Contact Mechanics of the Tibiofemoral Joint

Patients undergoing posterior cruciate ligament (PCL) reconstruction may experience changes in the mechanical environment of cartilage and meniscus; however, limited information is available regarding the contact mechanism of the tibiofemoral joint following different PCL reconstruction techniques. In this study, finite element (FE) models of the PCL-reconstructed tibiofemoral joint—including the femur, tibia, fibula, menisci, cartilage and ligaments (ACL, PCL, MCL and LCL)—were developed with contact interactions among these tissues considered. Joint angles and axial forces based on the ISO 14243-3 were used as inputs. Using these FE models, the effect of different PCL reconstruction techniques on contact pressure, stresses of the cartilages and menisci and tibiofemoral kinematics was evaluated. Compared to the intact model, PCL-reconstructed models exhibited reduced anterior translation during swing phase and reduced external rotation during stance phase. The external rotation of the TA model was greater than that of the intact model, TI model and TL model during swing phase. The medial meniscus of the PCL-reconstructed models experienced lower contact pressure and stresses compared to that in the intact model. The altered kinematics and contact mechanics of the PCL-reconstructed models demonstrate that the typical PCL reconstruction techniques should be improved or adjusted to better restore the natural biomechanical function of the joint.