Transtibial Versus Tibial Inlay Techniques for Posterior Cruciate Ligament Reconstruction

Abstract

Clinical and radiographic outcomes between the 2 PCL reconstruction techniques were comparable. Osteoarthritis was observed in patients, with a significant proportion presenting loss of joint space. Examined factors, excluding meniscectomy, were not correlated with the development of osteoarthritis.

All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique

“…9 In a study by Fanelli et al 10 no difference in clinical outcomes was appreciated between single-and double-bundle PCL reconstruction techniques.…”

What Role Does Low Bone Mineral Density Play in the “Killer Turn” Effect after Transtibial Posterior Cruciate Ligament Reconstruction?

“…On the tibia specimens, the native PCL footprint was identified before the PCL fibers were removed, leaving the remnants of the fibrous attachments intact. The Achilles tendon autograft was then harvested.…”

“…The transtibial technique is a popular technique of PCL reconstruction. Although the transtibial technique has the advantages of patient positioning and lower technical difficulty, the “killer turn” has frequently been documented as a primary drawback of this technique. Given the anatomy of the tibial posterior cortex and the direction of tibial and femoral tunnels, there is a sharp angle of the graft at the inlet of the proximal tibial tunnel, which is referred as the “killer turn” after transtibial PCL reconstruction.…”

“…The mechanism of the “killer turn” effect is conventionally believed to be a permanent elongation of the graft caused by thinning from repetitive abrasion between the bone and the graft. Because the ligament is less abrasion‐resistant compared to the posterior tibial cortex, it is usually the graft rather than the proximal posterior cortex that becomes attenuated and elongated.…”

Anatomic posterior cruciate ligament reconstruction: State of the Art

“…Although studies with long follow-up reported that degenerative changes occur mainly in the medial and patellofemoral compartments,38 39 Kim et al 40 were unable to define the overall prevalence, location or predictors of OA in a systematic review.…”