Anterolateral Transtibial Posterior Cruciate Ligament Reconstruction Combined With Anatomical Reconstruction of Posterolateral Corner Insufficiency

Kim, Sung-Jae; Jung, Min; Moon, Hee Koo; Kim, Sul-Gee; Chun, Yong-Min

doi:10.1177/0363546510385398

Cited by 55 publications

(80 citation statements)

References 34 publications

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“…20,21 Studies using the Lysholm test found no significant between-group difference in outcome (n ¼ 372; Figure 3). 9,[21][22][23][24][26][27][28][29] Those reporting the Tegner activity scale indicated significantly better outcomes after doublerather than single bundle reconstruction (n ¼ 247; OR À0.34, 95% CI À0.68, 0.00; Figure 4). 9,[21][22][23]26 The IKDC examination was reported in five studies (n ¼ 222) [20][21][22][23]28 with outcomes categorized as grade A or grades C/D (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

et al. 2015

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Objective: To test the hypothesis that double bundle posterior cruciate ligament (PCL) reconstruction yields better improvement in stability and functional recovery of the knee than the single bundle technique. Methods: PubMed Õ , Embase Õ , the Cochrane Library, CNKI, Wanfang and CBM disc databases were searched for comparative trials of PCL reconstruction using the single-versus double bundle technique. Data were extracted and meta-analysis was performed for stability improvement and functional recovery. Results: The meta-analysis included 435 patients in three randomized controlled trials (RCTs) and eight non-RCTs. Double bundle reconstruction provided significantly better 90 posterior stability than the single bundle technique (weighted mean difference 0.81, 95% confidence interval, [CI] 0.2, 1.42). Double bundle reconstruction resulted in a significantly higher likelihood of International Knee Documentation Committee (IKDC) examination grade A than the single bundle technique (odds ratio 0.41, 95% CI 0.24, 0.72). Conclusions: The small amount of data available indicates that double bundle reconstruction is superior to the single bundle technique after isolated PCL injury. These findings should be interpreted with caution due to the low quality and limited sample size of the studies concerned.

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Section: Resultsmentioning

confidence: 99%

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

et al. 2015

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“…Despite the paucity of high level evidence supporting double versus single bundle reconstruction, a recent large cohort study failed to demonstrate a difference in the clinical and functional outcome between the two techniques [8]. There is also a lack of prospective studies supporting superiority of transtibial versus tibial inlay techniques; the evidence available suggests satisfactory results in both approaches and choice is often due to surgeons experience [10].…”

Section: Discussionmentioning

confidence: 99%

“…There is also a lack of prospective studies supporting superiority of transtibial versus tibial inlay techniques; the evidence available suggests satisfactory results in both approaches and choice is often due to surgeons experience [10]. According to the available literature, better results with double bundle tibial inlay PCL reconstruction are only found in multiligaments injury cases [5,8]. Chamfering the sharp edges of the bone at the entrance of the tunnels in our experience helps reduce risk of reconstruction failure by graft abrasion without the need to alter the graft position angulation or tibial tunnel route suggested in other studies [12].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the lack of consensus on the most optimal reconstruction technique remains a reality. The debate most frequently relates to double versus single bundle reconstruction, graft choices, and transtibial versus tibial inlay approaches [8][9][10]. The principal aim of this study was to determine the long-term results based on clinical and functional assessment following arthroscopic single bundle transtibial PCL reconstruction using four strands hamstring tendon autograft.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes following single-bundle transtibial arthroscopic posterior cruciate ligament reconstruction

Boutefnouchet

Bentayeb

Qadri

et al. 2012

International Orthopaedics (SICOT)

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Purpose Posterior cruciate ligament (PCL) injury has a reported incidence of 3-20 %. PCL reconstruction is aimed at reducing onset of premature articular degeneration and improving function. Numerous operative techniques have been described with varying degrees of result consistency. Methods We evaluated 15 patients treated for isolated primary posterior cruciate ligament injury with a mean follow-up of 4.1 years (range one to nine). Post-reconstruction clinical assessment included the Lysholm and Tegner knee scoring scale, international knee documentation committee (IKDC) ligament evaluation, and KT2000 arthrometer assessment. Results On the Lysholm knee score 11 patients (73 %) had excellent results, three patients (20 %) had good results and one patient (7 %) had a poor result. On the Tegner activity score the majority of patients scored 7-8 with a return to high level sports. At the final follow-up, the postreconstruction IKDC score was normal or nearly normal (A and B) in 14 (93 %) patients, and abnormal (C) in one (7 %) patient. According to KT-2000 arthrometer measurements at final follow-up review, 11 patients (73 %) were rated as normal (A, 0-2 mm), and four patients (27 %) as nearly normal (B, 3-5 mm). These results were independent of age, mechanism of injury, time elapsed to surgical reconstruction, and length of follow-up. Conclusions Despite being a technically demanding procedure, the outcomes reported in this study show that single bundle transtibial arthroscopic PCL repair using four strands hamstring autograft provides satisfactory and consistent functional outcomes.

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“…The studies supporting this idea utilized conventional static uniplanar testing to assess stability in the ligament-deficient and reconstructed state. However, clinical studies evaluating PCL and PLC reconstruction [17,20,36,39] have failed to demonstrate a correlation between the degree of knee laxity measured by uniplanar testing and subjective outcomes.…”

Section: Introductionmentioning

confidence: 99%

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

Petrigliano

Lane

Suero

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background As measured via static stability tests, the PCL is the dominant restraint to posterior tibial translation while the posterolateral corner is the dominant restraint to external tibial rotation. However, these uniplanar static tests may not predict multiplanar instability. The reverse pivot shift is a dynamic examination maneuver that may identify complex knee instability. Questions/purposes In this cadaver study, we asked whether (1) isolated sectioning or (2) combined sectioning of the PCL and posterolateral corner increased the magnitude of the reverse pivot shift and (3) the magnitude of the reverse pivot shift correlated with static external rotation or posterior drawer testing. Methods In Group I, we sectioned the PCL followed by structures of the posterolateral corner. In Group II, we sectioned the posterolateral corner structures before sectioning the PCL. We performed posterior drawer, external rotation tests, and mechanized reverse pivot shift for each specimen under each condition and measured translations via navigation. Results Isolated sectioning of the PCL or posterolateral corner had no effect on the reverse pivot shift. Conversely, combined sectioning of the PCL and posterolateral corner structures increased the magnitude of the reverse pivot shift. The magnitude of the reverse pivot shift correlated with the posterior drawer and external rotation tests. Conclusions Combined sectioning of the PCL and posterolateral corner was required to cause an increase in the magnitude of the mechanized reverse pivot shift. The reverse pivot shift correlated with both static measures of stability. Clinical RelevanceCombined injury to the PCL and posterolateral corner should be considered in the presence of a positive reverse pivot shift.

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Anterolateral Transtibial Posterior Cruciate Ligament Reconstruction Combined With Anatomical Reconstruction of Posterolateral Corner Insufficiency

Abstract: In this series, double-bundle PCL reconstruction combined with posterolateral corner reconstruction did not appear to have advantages over single-bundle PCL reconstruction combined with posterolateral corner reconstruction with respect to the clinical outcomes or posterior knee stability.

Cited by 55 publications

References 34 publications

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

Long-term outcomes following single-bundle transtibial arthroscopic posterior cruciate ligament reconstruction

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

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