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Surgical Techniques   |    
Comparison of the Clinical Results of Three Posterior Cruciate Ligament Reconstruction TechniquesSurgical Technique
Sung-Jae Kim, MD1; Sung-Hwan Kim, MD1; Sul-Gee Kim, MD1; Yun-Pei Kung, MD1
1 Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University Health System, College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-P. Kung: ypkung@gmail.com
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DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University Health System, College of Medicine, Seoul, South Korea
The original scientific article in which the surgical technique was presented was published in JBJS Vol. 91-A, pp. 2543-9, November 2009

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Sep 01;92(Supplement 1 Part 2):145-157. doi: 10.2106/JBJS.J.00185
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Abstract

BACKGROUND: 

Despite its technical complexity, arthroscopic tibial inlay reconstruction of the posterior cruciate ligament has biomechanical advantages over transtibial procedures. The purpose of this study was to compare the clinical results of arthroscopic tibial inlay single-bundle and double-bundle techniques with those of the conventional transtibial single-bundle technique.

METHODS: 

We evaluated twenty-nine patients treated with primary posterior cruciate ligament reconstruction and followed for longer than two years. Eight patients were treated with a transtibial single-bundle procedure; eleven, with an arthroscopic inlay single-bundle procedure; and ten, with an arthroscopic inlay double-bundle procedure. An Achilles tendon allograft was used in all cases. Each patient was evaluated on the basis of the Lysholm knee score, the mean side-to-side difference in tibial translation as measured on Telos stress radiographs, and the side-to-side difference in the range of motion of the knee.

RESULTS: 

The mean side-to-side difference (and standard deviation) in posterior tibial translation differed significantly between the arthroscopic tibial inlay double-bundle group (3.6 ± 1.43 mm) and the transtibial single-bundle group (5.6 ± 2.0 mm) (p = 0.023), although there was no significant difference between the arthroscopic inlay single-bundle group (4.7 ± 1.62 mm) and the transtibial group (p = 0.374). The mean range of motion and Lysholm scores were similar among the three groups.

CONCLUSIONS: 

Despite its technical difficulty, the arthroscopic tibial inlay double-bundle technique is our preferred method of reconstruction of the posterior cruciate ligament because it stabilizes posterior tibial translation better than do the other two methods.

LEVEL OF EVIDENCE: 

Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION: 

"Comparison of the Clinical Results of Three Posterior Cruciate Ligament Reconstruction Techniques" (2009;91:2543-9).

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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