Comparison of the clinical results of three posterior cruciate ligament reconstruction techniques: surgical technique.
BACKGROUND
Despite its technical complexity, arthroscopic tibial inlay reconstruction of the posterior cruciate ligament has biomechanical advantages over transtibial procedures. The purpose of this study was to compare the clinical results of arthroscopic tibial inlay single-bundle and double-bundle techniques with those of the conventional transtibial single-bundle technique.


METHODS
We evaluated twenty-nine patients treated with primary posterior cruciate ligament reconstruction and followed for longer than two years. Eight patients were treated with a transtibial single-bundle procedure; eleven, with an arthroscopic inlay single-bundle procedure; and ten, with an arthroscopic inlay double-bundle procedure. An Achilles tendon allograft was used in all cases. Each patient was evaluated on the basis of the Lysholm knee score, the mean side-to-side difference in tibial translation as measured on Telos stress radiographs, and the side-to-side difference in the range of motion of the knee.


RESULTS
The mean side-to-side difference (and standard deviation) in posterior tibial translation differed significantly between the arthroscopic tibial inlay double-bundle group (3.6 ± 1.43 mm) and the transtibial single-bundle group (5.6 ± 2.0 mm) (p = 0.023), although there was no significant difference between the arthroscopic inlay single-bundle group (4.7 ± 1.62 mm) and the transtibial group (p = 0.374). The mean range of motion and Lysholm scores were similar among the three groups.


CONCLUSIONS
Despite its technical difficulty, the arthroscopic tibial inlay double-bundle technique is our preferred method of reconstruction of the posterior cruciate ligament because it stabilizes posterior tibial translation better than do the other two methods.
Kim
Sung-Jae
SJ
Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University Health System, College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea.
Kim
Sung-Hwan
SH
Kim
Sul-Gee
SG
Kung
Yun-Pei
YP
D000125:Achilles Tendon / Q000601:surgery / Q000637:transplantation*; D001182:Arthroscopy / Q000379:methods*; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D013997:Time Factors; D016378:Tissue Transplantation / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome