Nonanatomic Posteromedial Bundle Augmentation of the Posterior Cruciate Ligament after Hyperextension Trauma

Maximiliano Ibañez; Jérôme Valcarenghi; Felix Hoffmann; Caroline Mouton; Charles Pioger; Renaud Siboni; Joan Carles Monllau; Romain Seil

doi:10.1016/j.eats.2024.103013

Nonanatomic Posteromedial Bundle Augmentation of the Posterior Cruciate Ligament after Hyperextension Trauma

Arthrosc Tech. 2024 Apr 27;13(8):103013. doi: 10.1016/j.eats.2024.103013. eCollection 2024 Aug.

Authors

Maximiliano Ibañez^{1

2}, Jérôme Valcarenghi^{1

3}, Felix Hoffmann¹, Caroline Mouton^{1

4}, Charles Pioger^{1

5}, Renaud Siboni^{1

6}, Joan Carles Monllau^{2

7}, Romain Seil^{1

4

8}

Affiliations

¹ Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg.
² ICATME, Hospital Universitari Dexeus, UAB, Barcelona, Spain.
³ Department of Orthopaedic Surgery, Centre Hospitalier Universitaire d'Ambroise, Paré, Mons, Belgium.
⁴ Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg.
⁵ Department of Orthopaedic Surgery, Ambroise Paré Hospital, Paris Saclay University, Boulogne-Billancourt, France.
⁶ Department of Orthopaedic Surgery, Reims Teaching Hospital, Hôpital Maison Blanche, Reims, France.
⁷ Department of Orthopaedic Surgery, Parc de Salut Mar, Hospital de la Esperanza, Universitat Autònoma de Barcelona, Barcelona, Spain.
⁸ Human Motion, Orthopaedics, Sports Medicine and Digital Methods (HOSD), Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg.

Abstract

The surgical management of posterior cruciate ligament (PCL) injuries can be challenging. As most PCL injuries occur in a flexed knee position, the anterolateral bundle is thought to be more commonly injured than the posteromedial bundle (PMB); however, in hyperextension, the PMB plays a more significant role. The smaller size of the PMB compared with the anterolateral bundle and its lower strength may explain why isolated hyperextension PMB injuries can be easily overlooked. In this Technical Note, a surgical technique to perform a nonanatomic PMB augmentation of the PCL using a gracilis tendon autograft or allograft is reported. These technical features aim to overcome current limitations in existing techniques to address the symptoms after partial PCL hyperextension injuries.