Posterior cruciate ligament reconstruction via tibial inlay technique in multiligament knee injuries.
OBJECTIVE
The aim of this study is to report our institution's experience regarding the use of open tibial inlay technique in patients undergoing single-stage combined posterior cruciate ligament (PCL) reconstruction.


METHODS
Records of 17 patients who underwent PCL reconstruction with tibial inlay technique were retrospectively reviewed. Patients with ipsilateral femoral or tibial osteochondral avulsion fractures or ipsilateral concomitant tibia and femur shaft fractures were excluded. Out of these 17 patients, six cases underwent anterior cruciate ligament (ACL) + PCL reconstruction, nine cases underwent ACL+ PCL + posterolateral corner reconstruction, one case underwent ACL + PCL + MCL reconstruction and one case underwent ACL+ PCL + posterolateral corner + MCL reconstruction. Mean follow-up was 14.27±6.77 (range: 6-30) months.


RESULTS
In preoperative assessments, all patients had 3+ posterior laxity in posterior drawer test; at final follow-up, 6 patients had 0 laxity, 7 patients had 1+ laxity, and 4 patients had 2+ laxity (p<0.001). International Knee Documentation Committee (IKDC) objective evaluation showed severe disability in all patients preoperatively, whereas 5 knees were grade A, 8 knees were grade B, 3 knees were grade C, and 1 knee was grade D at final follow-up. Mean IKDC subjective score was 75.22±7.53 at final follow-up. Postoperatively, mean side-to-side difference in KT-1000 arthrometer measurement was 2.45±1.80 mm. At final follow-up, mean range of motion (ROM) was 0º on extension and 123.56±6.31º on flexion.


CONCLUSIONS
Open tibial inlay approach is beneficial during PCL reconstruction. Further study is warranted to establish its effectiveness on functional outcomes and prevention of complications.
Hitit University Faculty of Medicine, Department of Orthopaedics and Traumatology, Çorum, Turkey. sinanzehir@yahoo.com.
Sinan
S
Zehir
Bezmi Alem Vakıf University, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Nurzat
N
Elmalı
Bülent Ecevit University Faculty of Medicine, Department of Orthopedics and Traumatology, Zonguldak, Turkey.
Ercan
E
Şahin
Hitit University Faculty of Medicine, Department of Orthopaedics and Traumatology, Çorum, Turkey.
Murat
M
Çalbıyık
İnönü University Faculty of Medicine, Department of Orthopedics and Traumatology, Malatya, Turkey.
Mustafa
M
Karakaplan
Bezmi Alem Vakıf University, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Zeki
Z
Taşdemir
D000125:Achilles Tendon / Q000601:surgery; D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult