Clinical, Functional, and Morphological Evaluations of Posterior Cruciate Ligament Reconstruction With Remnant Preservation

Abstract

Transtibial PCL reconstruction with remnant preservation resulted in satisfactory clinical, functional, radiological, and morphological outcomes. The results of combined posterolateral rotatory instability were comparable with those for isolated PCL reconstruction with adequate PLC reconstruction.

The Arthroscopic All-Inside Tibial-Inlay Reconstruction of the Posterior Cruciate Ligament: Medium-Term Functional Results and Complication Rate

“…[4][5][6][7][8][9] Compared with Song et al, who report a Lysholm score of 92 with a minimum of 80 points and a Tegner level of 6 in their longterm study, 25 our observation finds similar high-activity levels but confirms slightly lower and more frequent results in literature regarding Lysholm and IKDC scores between 2 and 6 years postoperatively 1,8,9,12,16,22 with comparable high patient satisfaction. 1,8,9,12,16,22 Analyzing the 15 month results of a full arthroscopic inlay technique, Mariani et al found an IKDC rating of A for effusion and range of motion, normal and nearly normal assessment in overall IKDC scores in 56% of cases, and a side-toside difference in arthrometry of 3.6 mm. 26 The biomechanical evaluation of arthroscopic versus open tibial inlay techniques yielded similar initial fixation strength for both groups.…”

“…Although laboratory investigations have obtained positive results with stable fixation and anatomic tunnel replication, no clear evidence of clinical superiority of a reconstruction procedure has been reported. 5,8,[11][12][13] Therefore, optimal surgical tunnel construction, 7,8,14,15 graft choice, 12,16,17 graft placement 13,[18][19][20][21] or single-bundle versus double-bundle procedures 6,22,23 are still debatable. Evolving trends in PCL surgery include an arthroscopic all-inside tibial-inlay technique, which combines the benefits of biomechanically improved graft position avoiding a transtibial killer turn and of a minimally invasive arthroscopic approach.…”

KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review

“…Four studies demonstrated no difference in postoperative scores in patients treated with isolated PLC reconstruction versus those treated with combined PLC/cruciate ligament reconstruction 9 21 24 25. Similarly, there was no difference in postoperative scores in patients treated with isolated PCL versus those treated with combined PCL/other ligament reconstructions 26 27. Cartwright-Terry et al 12 reported a lower mean IKDC score in patients treated with combined ACL/PLC reconstructions (80) compared with those treated with isolated ACL reconstruction (87) at 2 years postoperatively, but scores did not differ at the preoperative or other postoperative times (1 and 5 years).…”

The predictive effect of anatomic femoral and tibial graft tunnel placement in posterior cruciate ligament reconstruction on functional and radiological outcome

“…Biomechanical data argue in favour of anatomic ligament replication to restore optimal stability [5, 6, 9, 10, 22-25, 28, 32]. Clinical assessments following transtibial and tibial inlay techniques yield satisfactory and promising results [1,8,16,18,21,30,35]. Since several co-variables affect the long-term outcome of PCL reconstruction, the verification of predictive values that assure high patient satisfaction and pre-injury knee function hardly seems to be realistic.…”

“…Nevertheless, the ideal management protocol is controversially discussed [18,29,33,35]. Optimal surgical tunnel construction [9,17,32], graft choice [18,19], graft placement [20,24,30] and single-versus double-bundle procedures [3,6,16] are still debatable, however. Correct graft tunnel placement has been identified as an essential factor influencing functional outcome and stability [4,10,22,28].…”