Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Patella-tibial transfixation for posterior cruciate ligament repair and reconstruction: a biomechanical analysis

  • 80 Accesses

  • 6 Citations


The posterior cruciate ligament (PCL) restricts posterior translation of the tibia on the femur. Because flexion of the knee increases tension on the PCL, the knee is usually immobilized in extension after PCL repair or reconstruction. Patella-tibial transfixation (olecranization), however, has been proposed to reduce the tension on the PCL without requiring immobilization of the knee. The objective of this study was: (1) to evaluate the distribution of strain in the anterolateral and posterior oblique fiber bundles of the PCLs in eight cadaveric knees before and after olecranization and (2) to measure the patellofemoral contact pressures at various degrees of knee flexion. Olecranization significantly (P < 0.05) reduced the strain on the anterolateral fiber bundles of the PCL at 15°–45° of flexion. No significant strain reduction was observed in the posterior oblique fiber bundles. Patellofemoral contact pressures measured from digitized Fuji sensitive film indicated significantly increased contact pressures (P < 0.05) following olecranization from 0°–60° of knee flexion. Increased parapatellar soft tissue tightness limited knee flexion to 90° and patella lift-off occurred at 75°. Although olecranization of the patella does reduce strain on the intact PCL within a selected range of motion, the beneficial effect of allowing early motion may be negated by the potentially harmful effects imposed upon the patellofemoral articular cartilage by increased contact pressures.

This is a preview of subscription content, log in to check access.

Author information

Additional information

Received: 20 December 1996 Accepted: 24 June 1997

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kambic, H., Dass, A. & Andrish, J. Patella-tibial transfixation for posterior cruciate ligament repair and reconstruction: a biomechanical analysis. Knee Surgery 5, 245–250 (1997). https://doi.org/10.1007/s001670050058

Download citation

  • Key words Olecranization
  • Posterior cruciate ligament
  • Strain
  • Rehabilitation