Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 2/2018

01-06-2018 | PCL Update (K Jones and M Alaia, section editors)

Arthroscopic Transtibial PCL Reconstruction: Surgical Technique and Clinical Outcomes

Authors: Jessica Shin, Travis G. Maak

Published in: Current Reviews in Musculoskeletal Medicine | Issue 2/2018

Login to get access

Abstract

Purpose of review

Posterior cruciate ligament (PCL) injuries are relatively uncommon injuries. As such, there is a dearth of high-quality studies in the literature examining the operative management of PCL injuries and a lack of clear consensus on what the optimal method should be. The goal of this review was to conduct a comprehensive evaluation of recent literature and provide an evidence-based algorithm to optimize surgical decision-making and outcomes for PCL reconstruction.

Recent findings

Recent literature confirms that transtibial PCL reconstruction is a reliable and reproducible method to manage PCL injuries and results in satisfactory patient outcomes. However, there does not yet appear to be enough new, compelling information to conclusively determine an optimal method for surgical management.

Summary

Our preferred method of management for operative PCL injuries is a single bundle transtibial PCL reconstruction, which is supported by the current body of literature. Future high-quality research studies are necessary to further guide treatment algorithms.
Literature
1.
go back to reference Gill TJ, DeFrate LE, Wang C, et al. The biomechanical effect of posterior cruciate ligament reconstruction on knee joint function: kinematic response to simulated muscle loads. Am J Sports Med. 2003;31(4):530–6.CrossRefPubMed Gill TJ, DeFrate LE, Wang C, et al. The biomechanical effect of posterior cruciate ligament reconstruction on knee joint function: kinematic response to simulated muscle loads. Am J Sports Med. 2003;31(4):530–6.CrossRefPubMed
2.
go back to reference Gollehon DL, Torzilli PA, Warren RF. The role of the posterolateral and cruciate ligaments in the stability of the human knee: a biomechanical study. J Bone Joint Surg Am. 1987;69(2):233–42.CrossRefPubMed Gollehon DL, Torzilli PA, Warren RF. The role of the posterolateral and cruciate ligaments in the stability of the human knee: a biomechanical study. J Bone Joint Surg Am. 1987;69(2):233–42.CrossRefPubMed
3.
go back to reference Harner CD, Janaushek MA, Kanamori A, Yagi M, Vogrin TM, Woo SL. Biomechanical analysis of a double-bundle posterior cruciate ligament reconstruction. Am J Sports Med. 2000;28(2):144–51.CrossRefPubMed Harner CD, Janaushek MA, Kanamori A, Yagi M, Vogrin TM, Woo SL. Biomechanical analysis of a double-bundle posterior cruciate ligament reconstruction. Am J Sports Med. 2000;28(2):144–51.CrossRefPubMed
4.
go back to reference Kennedy NI, Wijdicks CA, Goldsmith MT, Michalski MP, Devitt BM, Årøen A, et al. Kinematic analysis of the posterior cruciate ligament, part 1: the individual and collective function of the anterolateral and posteromedial bundles. Am J Sports Med. 2013;41(12):2828–38.CrossRefPubMed Kennedy NI, Wijdicks CA, Goldsmith MT, Michalski MP, Devitt BM, Årøen A, et al. Kinematic analysis of the posterior cruciate ligament, part 1: the individual and collective function of the anterolateral and posteromedial bundles. Am J Sports Med. 2013;41(12):2828–38.CrossRefPubMed
5.
go back to reference Li G, Gill TJ, DeFrate LE, Zayontz S, Glatt V, Zarins B. Biomechanical consequences of PCL deficiency in the knee under simulated muscle loads—an in vitro experimental study. J Orthop Res. 2002;20(4):887–92.CrossRefPubMed Li G, Gill TJ, DeFrate LE, Zayontz S, Glatt V, Zarins B. Biomechanical consequences of PCL deficiency in the knee under simulated muscle loads—an in vitro experimental study. J Orthop Res. 2002;20(4):887–92.CrossRefPubMed
6.
go back to reference Margheritini F, Rihn JA, Mauro CS, Stabile KJ, Woo SL, Harner CD. Biomechanics of initial tibial fixation in posterior cruciate ligament reconstruction. Arthroscopy. 2005;21(10):1164–71.CrossRefPubMed Margheritini F, Rihn JA, Mauro CS, Stabile KJ, Woo SL, Harner CD. Biomechanics of initial tibial fixation in posterior cruciate ligament reconstruction. Arthroscopy. 2005;21(10):1164–71.CrossRefPubMed
7.
go back to reference Markolf KL, Feeley BT, Tejwani SG, Martin DE, McAllister DR. Changes in knee laxity and ligament force after sectioning the posteromedial bundle of the posterior cruciate ligament. Arthroscopy. 2006;22(10):1100–6.CrossRefPubMed Markolf KL, Feeley BT, Tejwani SG, Martin DE, McAllister DR. Changes in knee laxity and ligament force after sectioning the posteromedial bundle of the posterior cruciate ligament. Arthroscopy. 2006;22(10):1100–6.CrossRefPubMed
8.
go back to reference Mauro CS, Sekiya JK, Stabile KJ, Haemmerle MJ, Harner CD. Double-bundle PCL and posterolateral corner reconstruction components are codominant. Clin Orthop Relat Res. 2008;466(9):2247–54.CrossRefPubMedPubMedCentral Mauro CS, Sekiya JK, Stabile KJ, Haemmerle MJ, Harner CD. Double-bundle PCL and posterolateral corner reconstruction components are codominant. Clin Orthop Relat Res. 2008;466(9):2247–54.CrossRefPubMedPubMedCentral
9.
go back to reference Papannagari R, DeFrate LE, Nha KW, et al. Function of posterior cruciate ligament bundles during in vivo knee flexion. Am J Sports Med. 2007;35(9):1507–12.CrossRefPubMed Papannagari R, DeFrate LE, Nha KW, et al. Function of posterior cruciate ligament bundles during in vivo knee flexion. Am J Sports Med. 2007;35(9):1507–12.CrossRefPubMed
10.
go back to reference Ahmad CS, Cohen ZA, Levine WN, Gardner TR, Ateshian GA, Mow VC. Codominance of the individual posterior cruciate ligament bundles: an analysis of bundle lengths and orientation. Am J Sports Med. 2003;31(2):221–5.CrossRefPubMed Ahmad CS, Cohen ZA, Levine WN, Gardner TR, Ateshian GA, Mow VC. Codominance of the individual posterior cruciate ligament bundles: an analysis of bundle lengths and orientation. Am J Sports Med. 2003;31(2):221–5.CrossRefPubMed
11.
go back to reference Amis AA, Bull AM, Gupte CM, Hijazi I, Race A, Robinson JR. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2003;11(5):271–81.CrossRefPubMed Amis AA, Bull AM, Gupte CM, Hijazi I, Race A, Robinson JR. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2003;11(5):271–81.CrossRefPubMed
12.
go back to reference Gupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy. 2003;19(2):161–71.CrossRefPubMed Gupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy. 2003;19(2):161–71.CrossRefPubMed
13.
go back to reference Shelbourne KD, Davis TJ, Patel DV. The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries: a prospective study. Am J Sports Med. 1999;27(3):276–83.CrossRefPubMed Shelbourne KD, Davis TJ, Patel DV. The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries: a prospective study. Am J Sports Med. 1999;27(3):276–83.CrossRefPubMed
14.
go back to reference Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients, part II. Arthroscopy. 1995;11(5):526–9.CrossRefPubMed Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients, part II. Arthroscopy. 1995;11(5):526–9.CrossRefPubMed
15.
go back to reference Rubinstein RA Jr, Shelbourne KD, McCarroll JR, VanMeter CD, Rettig AC. The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med. 1994;22(4):550–7.CrossRefPubMed Rubinstein RA Jr, Shelbourne KD, McCarroll JR, VanMeter CD, Rettig AC. The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med. 1994;22(4):550–7.CrossRefPubMed
16.
go back to reference Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am. 1991;73(1):2–10.CrossRefPubMed Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD. Accuracy of diagnoses from magnetic resonance imaging of the knee: a multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am. 1991;73(1):2–10.CrossRefPubMed
17.
go back to reference Gross ML, Grover JS, Bassett LW, Seeger LL, Finerman GA. Magnetic resonance imaging of the posterior cruciate ligament: clinical use to improve diagnostic accuracy. Am J Sports Med. 1992;20(6):732–7.CrossRefPubMed Gross ML, Grover JS, Bassett LW, Seeger LL, Finerman GA. Magnetic resonance imaging of the posterior cruciate ligament: clinical use to improve diagnostic accuracy. Am J Sports Med. 1992;20(6):732–7.CrossRefPubMed
18.
go back to reference Polly DW Jr, Callaghan JJ, Sikes RA, McCabe JM, McMahon K, Savory CG. The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg Am. 1988;70(2):192–8.CrossRefPubMed Polly DW Jr, Callaghan JJ, Sikes RA, McCabe JM, McMahon K, Savory CG. The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg Am. 1988;70(2):192–8.CrossRefPubMed
19.
go back to reference Jackman T, LaPrade RF, Pontinen T, Lender PA. Intraobserver and interobserver reliability of the kneeling technique of stress radiography for the evaluation of posterior knee laxity. Am J Sports Med. 2008;36(8):1571–6.CrossRefPubMed Jackman T, LaPrade RF, Pontinen T, Lender PA. Intraobserver and interobserver reliability of the kneeling technique of stress radiography for the evaluation of posterior knee laxity. Am J Sports Med. 2008;36(8):1571–6.CrossRefPubMed
20.
go back to reference Jung TM, Reinhardt C, Scheffler SU, Weiler A. Stress radiography to measure posterior cruciate ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc. 2006;14(11):1116–21.CrossRefPubMed Jung TM, Reinhardt C, Scheffler SU, Weiler A. Stress radiography to measure posterior cruciate ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc. 2006;14(11):1116–21.CrossRefPubMed
21.
go back to reference Schulz MS, Russe K, Lampakis G, Strobel MJ. Reliability of stress radiography for evaluation of posterior knee laxity. Am J Sports Med. 2005;33(4):502–6.CrossRefPubMed Schulz MS, Russe K, Lampakis G, Strobel MJ. Reliability of stress radiography for evaluation of posterior knee laxity. Am J Sports Med. 2005;33(4):502–6.CrossRefPubMed
22.
go back to reference Bergfeld JA, Graham SM, Parker RD, Valdevit AD, Kambic HE. A bio-mechanical comparison of posterior cruciate ligament reconstructions using single- and double-bundle tibial inlay techniques. Am J Sports Med. 2005;33(7):976–81.CrossRefPubMed Bergfeld JA, Graham SM, Parker RD, Valdevit AD, Kambic HE. A bio-mechanical comparison of posterior cruciate ligament reconstructions using single- and double-bundle tibial inlay techniques. Am J Sports Med. 2005;33(7):976–81.CrossRefPubMed
23.
go back to reference Bergfeld JA, McAllister DR, Parker RD, Valdevit AD, Kambic HE. A biomechanical comparison of posterior cruciate ligament reconstruction techniques. Am J Sports Med. 2001;29(2):129–36.CrossRefPubMed Bergfeld JA, McAllister DR, Parker RD, Valdevit AD, Kambic HE. A biomechanical comparison of posterior cruciate ligament reconstruction techniques. Am J Sports Med. 2001;29(2):129–36.CrossRefPubMed
24.
go back to reference Markolf KL, Zemanovic JR Matava MJ, Ellis E, Gruber B. Surgical treatment of posterior cruciate ligament tears: an evolving technique. J Am Acad Orthop Surg. 2009;17(7):435–46.CrossRef Markolf KL, Zemanovic JR Matava MJ, Ellis E, Gruber B. Surgical treatment of posterior cruciate ligament tears: an evolving technique. J Am Acad Orthop Surg. 2009;17(7):435–46.CrossRef
25.
go back to reference McAllister DR. Cyclic loading of posterior cruciate ligament replacements fixed with tibial tunnel and tibial inlay methods. J Bone Joint Surg Am. 2002;84(4):518–24.PubMed McAllister DR. Cyclic loading of posterior cruciate ligament replacements fixed with tibial tunnel and tibial inlay methods. J Bone Joint Surg Am. 2002;84(4):518–24.PubMed
26.
go back to reference Margheritini F, Mauro CS, Rihn JA, Stabile KJ, Woo SL, Harner CD. Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: analysis of knee kinematics and graft in situ forces. Am J Sports Med. 2004;32(3):587–93.CrossRefPubMed Margheritini F, Mauro CS, Rihn JA, Stabile KJ, Woo SL, Harner CD. Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: analysis of knee kinematics and graft in situ forces. Am J Sports Med. 2004;32(3):587–93.CrossRefPubMed
27.
go back to reference Ahn JH, Yang HS, Jeong WK, Koh KH. Arthroscopic transtibial posterior cruciate ligament reconstruction with preservation of posterior cruciate ligament fibers: clinical results of minimum 2-year follow-up. Am J Sports Med. 2006;34(2):194–204.CrossRefPubMed Ahn JH, Yang HS, Jeong WK, Koh KH. Arthroscopic transtibial posterior cruciate ligament reconstruction with preservation of posterior cruciate ligament fibers: clinical results of minimum 2-year follow-up. Am J Sports Med. 2006;34(2):194–204.CrossRefPubMed
28.
go back to reference Noyes FR, Barber-Westin S. Posterior cruciate ligament replacement with a two-strand quadriceps tendon-patellar bone autograft and a tibial inlay technique. J Bone Joint Surg Am. 2005;87(6):1241–52.PubMed Noyes FR, Barber-Westin S. Posterior cruciate ligament replacement with a two-strand quadriceps tendon-patellar bone autograft and a tibial inlay technique. J Bone Joint Surg Am. 2005;87(6):1241–52.PubMed
29.
go back to reference Cooper DE, Stewart D. Posterior cruciate ligament reconstruction using single-bundle patella tendon graft with tibial inlay fixation: 2- to 10-year follow-up. Am J Sports Med. 2004 Mar;32(2):346–60.CrossRefPubMed Cooper DE, Stewart D. Posterior cruciate ligament reconstruction using single-bundle patella tendon graft with tibial inlay fixation: 2- to 10-year follow-up. Am J Sports Med. 2004 Mar;32(2):346–60.CrossRefPubMed
30.
go back to reference Kim SJ, Kim TE, Jo SB, Kung YP. Comparison of the clinical results of three posterior cruciate ligament reconstruction techniques. J Bone Joint Surg Am. 2009 Nov;91(11):2543–9.CrossRefPubMed Kim SJ, Kim TE, Jo SB, Kung YP. Comparison of the clinical results of three posterior cruciate ligament reconstruction techniques. J Bone Joint Surg Am. 2009 Nov;91(11):2543–9.CrossRefPubMed
31.
go back to reference Stannard JP, Riley RS, Sheils TM, McGwin G, Volgas DA. Anatomic reconstruction of the posterior cruciate ligament after multiligament knee injuries. A combination of the tibial-inlay and two-femoral-tunnel techniques. Am J Sports Med. 2003;31(2):196–202.CrossRefPubMed Stannard JP, Riley RS, Sheils TM, McGwin G, Volgas DA. Anatomic reconstruction of the posterior cruciate ligament after multiligament knee injuries. A combination of the tibial-inlay and two-femoral-tunnel techniques. Am J Sports Med. 2003;31(2):196–202.CrossRefPubMed
32.
go back to reference MacGillivray JD, Stein BE, Park M, Allen AA, Wickiewicz TL, Warren RF. Comparison of tibial inlay versus transtibial techniques for isolated posterior cruciate ligament reconstruction: minimum 2-year follow-up. Arthroscopy. 2006;22(3):320–8.CrossRefPubMed MacGillivray JD, Stein BE, Park M, Allen AA, Wickiewicz TL, Warren RF. Comparison of tibial inlay versus transtibial techniques for isolated posterior cruciate ligament reconstruction: minimum 2-year follow-up. Arthroscopy. 2006;22(3):320–8.CrossRefPubMed
33.
go back to reference Seon JK, Song EK. Reconstruction of isolated posterior cruciate ligament injuries: a clinical comparison of the transtibial and tibial inlay techniques. Arthroscopy. 2006;22(1):27–32.CrossRefPubMed Seon JK, Song EK. Reconstruction of isolated posterior cruciate ligament injuries: a clinical comparison of the transtibial and tibial inlay techniques. Arthroscopy. 2006;22(1):27–32.CrossRefPubMed
34.
go back to reference Panchal HB, Sekiya JK. Open tibial inlay versus arthroscopic transtibial posterior cruciate ligament reconstructions. Arthroscopy. 2011;27(9):1289–95.CrossRefPubMed Panchal HB, Sekiya JK. Open tibial inlay versus arthroscopic transtibial posterior cruciate ligament reconstructions. Arthroscopy. 2011;27(9):1289–95.CrossRefPubMed
35.
go back to reference •• Song EK, Park HW, Ahn YS, Seon JK. Transtibial versus tibial inlay techniques for posterior cruciate ligament reconstruction: long-term follow-up study. Am J Sports Med. 2014;42(12):2964–71. Song and colleagues performed a study comparing outcomes at mean follow-up of 148 months between arthroscopic transtibial and open tibial inlay PCL reconstruction. They found that overall both groups improved significantly after surgery with outcomes being similar between the two groups. Meniscectomy at time of surgery appeared to correlate with development of arthritis in both groups. CrossRefPubMed •• Song EK, Park HW, Ahn YS, Seon JK. Transtibial versus tibial inlay techniques for posterior cruciate ligament reconstruction: long-term follow-up study. Am J Sports Med. 2014;42(12):2964–71. Song and colleagues performed a study comparing outcomes at mean follow-up of 148 months between arthroscopic transtibial and open tibial inlay PCL reconstruction. They found that overall both groups improved significantly after surgery with outcomes being similar between the two groups. Meniscectomy at time of surgery appeared to correlate with development of arthritis in both groups. CrossRefPubMed
36.
go back to reference Boutefnouchet T, Bentayeb M, Qadri Q, Ali S. Long-term outcomes following single-bundle transtibial arthroscopic posterior cruciate ligament reconstruction. Int Orthop. 2013 Feb;37(2):337–43.CrossRefPubMed Boutefnouchet T, Bentayeb M, Qadri Q, Ali S. Long-term outcomes following single-bundle transtibial arthroscopic posterior cruciate ligament reconstruction. Int Orthop. 2013 Feb;37(2):337–43.CrossRefPubMed
37.
go back to reference •• Shin YS, Kim HJ, Lee DH. No clinically important difference in knee scores or instability between transtibial and inlay techniques for PCL reconstruction: a systematic review. Clin Orthop Relat Res. 2017;475:1239–48. This study by Shin et al is a systematic review comparing Tegner and Lysholm scores as well as residual posterior laxity between groups that underwent single bundle PCL reconstruction with transtibial or tibial inlay techniques. They found that there were no clinically important differences in Tegner and Lysholm scores or with residual posterior laxity in the seven studies that were included as part of the review. CrossRefPubMed •• Shin YS, Kim HJ, Lee DH. No clinically important difference in knee scores or instability between transtibial and inlay techniques for PCL reconstruction: a systematic review. Clin Orthop Relat Res. 2017;475:1239–48. This study by Shin et al is a systematic review comparing Tegner and Lysholm scores as well as residual posterior laxity between groups that underwent single bundle PCL reconstruction with transtibial or tibial inlay techniques. They found that there were no clinically important differences in Tegner and Lysholm scores or with residual posterior laxity in the seven studies that were included as part of the review. CrossRefPubMed
38.
go back to reference • Li Y, Li J, Wang J, Gao S, Zhang Y. Comparison of single-bundle and double-bundle isolated posterior cruciate ligament reconstruction with allograft: a prospective, randomized study. Arthroscopy. 2014;30(6):695–700. This study by Li and colleagues is a prospective, randomized study of 50 patients who underwent either single bundle or double bundle arthroscopic transtibial PCL reconstruction. Results of the study showed that while subjective outcome scores were similar between the two groups, the double bundle group had a significantly smaller side-to-side difference in posterior translation when compared with the uninjured knee. CrossRefPubMed • Li Y, Li J, Wang J, Gao S, Zhang Y. Comparison of single-bundle and double-bundle isolated posterior cruciate ligament reconstruction with allograft: a prospective, randomized study. Arthroscopy. 2014;30(6):695–700. This study by Li and colleagues is a prospective, randomized study of 50 patients who underwent either single bundle or double bundle arthroscopic transtibial PCL reconstruction. Results of the study showed that while subjective outcome scores were similar between the two groups, the double bundle group had a significantly smaller side-to-side difference in posterior translation when compared with the uninjured knee. CrossRefPubMed
39.
go back to reference Yoon KH, Bae DK, Song SJ, Cho HJ, Lee JH. A prospective randomized study comparing arthroscopic single-bundle and double-bundle posterior cruciate ligament reconstructions preserving remnant fibers. Am J Sports Med. 2011;39(3):474–80.CrossRefPubMed Yoon KH, Bae DK, Song SJ, Cho HJ, Lee JH. A prospective randomized study comparing arthroscopic single-bundle and double-bundle posterior cruciate ligament reconstructions preserving remnant fibers. Am J Sports Med. 2011;39(3):474–80.CrossRefPubMed
40.
go back to reference Del Buono A, Radmilovic J, Gargano G, Gatto S, Maffulli N. Augmentation or reconstruction of PCL? A quantitative review. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1050–63.CrossRefPubMed Del Buono A, Radmilovic J, Gargano G, Gatto S, Maffulli N. Augmentation or reconstruction of PCL? A quantitative review. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1050–63.CrossRefPubMed
41.
go back to reference • Lee DW, Jang HW, Lee YS, Oh SJ, Kim JY, Song HE, et al. Clinical, functional, and morphological evaluations of posterior cruciate ligament reconstruction with remnant preservation: minimum 2-year follow-up. Am J Sports Med. 2014;42(8):1822–31. This study by Lee et al examines the minimum two year clinical outcomes and residual posterior instability in patients undergoing arthroscopic PCL reconstruction with remnant preservation with or without PLC reconstruction. Both clinical outcomes and posterior instability improved significantly. Postoperative proprioception was also assessed using the Biodex system and was found to have recovered to a level similar to the uninjured side at final follow-up. CrossRefPubMed • Lee DW, Jang HW, Lee YS, Oh SJ, Kim JY, Song HE, et al. Clinical, functional, and morphological evaluations of posterior cruciate ligament reconstruction with remnant preservation: minimum 2-year follow-up. Am J Sports Med. 2014;42(8):1822–31. This study by Lee et al examines the minimum two year clinical outcomes and residual posterior instability in patients undergoing arthroscopic PCL reconstruction with remnant preservation with or without PLC reconstruction. Both clinical outcomes and posterior instability improved significantly. Postoperative proprioception was also assessed using the Biodex system and was found to have recovered to a level similar to the uninjured side at final follow-up. CrossRefPubMed
42.
go back to reference Lee SH, Jung YB, Lee HJ, Jung HJ, Kim SH. Remnant preservation is helpful to obtain good clinical results in posterior cruciate ligament reconstruction: comparison of clinical results of three techniques. Clin Orthop Surg. 2013;5(4):278–86.CrossRefPubMedPubMedCentral Lee SH, Jung YB, Lee HJ, Jung HJ, Kim SH. Remnant preservation is helpful to obtain good clinical results in posterior cruciate ligament reconstruction: comparison of clinical results of three techniques. Clin Orthop Surg. 2013;5(4):278–86.CrossRefPubMedPubMedCentral
43.
go back to reference Hudgens JL, Gillette BP, Krych AJ, Stuart MJ, May JH, Levy BA. Allograft versus autograft in posterior cruciate ligament reconstruction: an evidence-based systematic review. J Knee Surg. 2013;26(2):109–U5.CrossRefPubMed Hudgens JL, Gillette BP, Krych AJ, Stuart MJ, May JH, Levy BA. Allograft versus autograft in posterior cruciate ligament reconstruction: an evidence-based systematic review. J Knee Surg. 2013;26(2):109–U5.CrossRefPubMed
44.
go back to reference Wang CJ, Chan YS, Weng LH, Yuan LJ, Chen HS. Comparison of autogenous and allogenous posterior cruciate ligament reconstructions of the knee. Injury. 2004;35:1279–85.CrossRefPubMed Wang CJ, Chan YS, Weng LH, Yuan LJ, Chen HS. Comparison of autogenous and allogenous posterior cruciate ligament reconstructions of the knee. Injury. 2004;35:1279–85.CrossRefPubMed
45.
go back to reference • Li B, Wang JS, He M, Wang GB, Shen P, Bai LH. Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):3077–84. In this study, Li and colleagues compare outcomes between hamstring autograft and tibialis anterior allograft single bundle transtibial PCL reconstruction. They found no differences between the two groups in regards to knee function and residual posterior laxity. Both groups improved significantly when compared to pre-operative status, however did continue to have residual laxity post-operatively that was worse than the uninjured knee. CrossRefPubMed • Li B, Wang JS, He M, Wang GB, Shen P, Bai LH. Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):3077–84. In this study, Li and colleagues compare outcomes between hamstring autograft and tibialis anterior allograft single bundle transtibial PCL reconstruction. They found no differences between the two groups in regards to knee function and residual posterior laxity. Both groups improved significantly when compared to pre-operative status, however did continue to have residual laxity post-operatively that was worse than the uninjured knee. CrossRefPubMed
46.
go back to reference • Kwon JH, Han JH, Jo DY, Park HJ, Lee SY, Bhandare N, et al. Tunnel volume enlargement after posterior cruciate ligament reconstruction: comparison of Achilles allograft with mixed autograft/allograft—a prospective computed tomography study. Arthroscopy. 2014;30(3):326–34. Kwon et al designed this study to assess for the overall incidence of tunnel volume enlargement (TVE) after PCL reconstruction with remnant preservation as well as to compare TVE when allograft or mixed autograft/allograft was used. They found that overall incidence of TVE was low for both the femoral and tibial tunnels. There was no significant difference in the TVE caused by single bundle PCL reconstruction when allograft or mixed autograft/allograft was used. CrossRefPubMed • Kwon JH, Han JH, Jo DY, Park HJ, Lee SY, Bhandare N, et al. Tunnel volume enlargement after posterior cruciate ligament reconstruction: comparison of Achilles allograft with mixed autograft/allograft—a prospective computed tomography study. Arthroscopy. 2014;30(3):326–34. Kwon et al designed this study to assess for the overall incidence of tunnel volume enlargement (TVE) after PCL reconstruction with remnant preservation as well as to compare TVE when allograft or mixed autograft/allograft was used. They found that overall incidence of TVE was low for both the femoral and tibial tunnels. There was no significant difference in the TVE caused by single bundle PCL reconstruction when allograft or mixed autograft/allograft was used. CrossRefPubMed
Metadata
Title
Arthroscopic Transtibial PCL Reconstruction: Surgical Technique and Clinical Outcomes
Authors
Jessica Shin
Travis G. Maak
Publication date
01-06-2018
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 2/2018
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9489-9

Other articles of this Issue 2/2018

Current Reviews in Musculoskeletal Medicine 2/2018 Go to the issue

Advances in Patellofemoral Surgery (L Redler, Section Editor)

Use of TT-PCL versus TT-TG

Advances in Patellofemoral Surgery (L Redler, Section Editor)

Femoral Derotational Osteotomies

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

The Swimmer’s Shoulder: Multi-directional Instability

Advances in Patellofemoral Surgery (L Redler, Section Editor)

Quadriceps Tendon Autograft Medial Patellofemoral Ligament Reconstruction

Advances in Patellofemoral Surgery (L Redler, Section Editor)

Trochleoplasty: Indications and Technique