title: Clinical comparison of conventional and remnant-preserving transtibial single-bundle posterior cruciate ligament reconstruction combined with posterolateral corner reconstruction.
abstract: BACKGROUND
  Despite persistent continuity of the attenuated posterior cruciate ligament (PCL) in most PCL insufficient knees, few reconstruction techniques that preserve the PCL remnant have been presented. Furthermore, data regarding the clinical outcomes of these approaches are even more limited, and the clinical validity of remnant preservation has not yet been established.
  
  
  OBJECTIVE
  To compare the clinical outcomes of transtibial PCL reconstructions that incorporate remnant preservation with conventional techniques (in which remnant preservation is not performed).
  
  
  METHODS
  Cohort study; Level of evidence 3.
  
  
  METHODS
  The authors retrospectively evaluated 53 cases of PCL reconstruction with simultaneous posterolateral corner reconstruction. Of these, 23 were performed with a conventional approach without remnant preservation (group C), and 30 incorporated a remnant-preserving technique (group R). In all cases, the minimum follow-up period was 24 months. Each patient was evaluated using the following variables: Lysholm knee score, Tegner activity scale, return to activity, International Knee Documentation Committee (IKDC) knee score and grade, and degree of posterior laxity on stress radiograph.
  
  
  RESULTS
  The mean side-to-side differences in posterior tibial translation, Lysholm knee score, return to activity, and objective IKDC grade were similar between group C (4.4 ± 3.0 mm; 82.6 ± 11.0; 21.7%; A and B: 73.9%) and group R (4.1 ± 3.4 mm; 84.1 ± 10.7; 26.7%; A and B: 83.3%; P = .761, .611, .679, .755). However, the final Tegner activity scale, near-return to activity, and subjective IKDC score differed significantly between group C (3.5 ± 0.8; 43.5%; 64.5 ± 8.8) and group R (4.3 ± 1.1; 73.3%; 70.6 ± 7.9; P = .007, .028, .012).
  
  
  CONCLUSIONS
  Techniques combining remnant-preserving transtibial single-bundle PCL reconstruction with posterolateral corner reconstruction resulted in somewhat better activity-related outcomes compared with those of approaches without remnant preservation. However, incorporation of remnant preservation does not appear to provide increased posterior stability or result in clinically superior outcomes versus those of techniques without remnant preservation.
authors: Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, 120-752, CPO Box 8044, 50 Yonsei-ro, Seodaemoon-gu, Seoul, Korea.
authors: Sung-Jae
authors: SJ
authors: Kim
authors: Sung-Hwan
authors: SH
authors: Kim
authors: Yong-Min
authors: YM
authors: Chun
authors: Byoung-Yoon
authors: BY
authors: Hwang
authors: Duck-Hyun
authors: DH
authors: Choi
authors: Ji-Young
authors: JY
authors: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D007718:Knee Injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D016119:Posterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult