The tibial inlay method for reconstruction of the posterior cruciate
ligament has been performed with the patient in the prone or lateral decubitus
position. The purpose of this report is to present a modification of this
method wherein the patient is positioned supine throughout the procedure.
Between May 1995 and September 1998, twelve patients who had an isolated
tear of the posterior cruciate ligament underwent reconstruction with use of
the modified tibial inlay technique. Eleven patients were evaluated after a
minimum duration of follow-up of two years. Stability was measured on
posterior stress radiographs and with a maximum manual displacement test
performed with a KT-1000 arthrometer. Clinical evaluation was carried out with
use of the scoring systems of the Orthopädische Arbeitsgruppe Knie and
the International Knee Documentation Committee. Second-look arthroscopy was
performed in five patients at the time of follow-up.
The mean side-to-side difference in displacement (and standard deviation)
was reduced from 10.8 ± 1.9 mm preoperatively to 3.4 ± 2.4 mm at
the time of follow-up as measured on the stress radiographs, and it was
reduced from 9.0 ± 2.1 mm preoperatively to 1.8 ± 1.2 mm at the
time of follow-up as measured with the KT-1000 arthrometer. The average
Orthopädische Arbeitsgruppe Knie score was improved from 71.6 ±
6.8 to 92.5 ± 4.8 points. All eleven patients had a satisfactory
clinical outcome at the time of the final clinical evaluation. The second-look
arthroscopic examination in the five patients showed no evidence of partial
tearing or abrasion of the graft.
Use of our modified tibial inlay technique for reconstruction of the
posterior cruciate ligament achieved a good clinical result in eleven of
twelve patients. The advantages of the technique are (1) minimal tendon
abrasion at the posterior opening of the tibial tunnel, and (2) elimination of
the need to change the patient's position during surgery.