Document Title: Stannard-AJSM-Mar03.shtml
Article Title: Anatomic Reconstruction of the Posterior Cruciate Ligament after Multiligament Knee Injuries: A Combination of the Tibial-Inlay and Two-Femoral-Tunnel Techniques
Authors: James P. Stannard, MD, Reneé S. Riley, MD, Todd M. Sheils, MD, Gerald McGwin, Jr, PhD and David A. Volgas, MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: March 2003
Volume 31, pages 196-202 (appended letters to the editor are from pages 812-814)
Keywords: PCL, posterior cruciate ligament, anatomic reconstruction, anatomically correct, double-bundle, twin-bundle, dual-bundle, tibial inlay.

(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)

Comments: This article discusses how to best reconstruct the PCL. Because of the PCL's very pronounced double-bundle structure, reconstructing the PCL with only a single bundle (as is typical for the ACL, which also contains more than one bundle but slightly less markedly so) is inherently inadequate.

Note: See Letter to the Editor (from Dr. Frank Noyes, who pioneered anatomic PCL reconstruction and has been using it since 1995) appended; also provided is the response from Dr. Stannard.

ABSTRACT Background: Neither operative nor nonoperative treatment of posterior cruciate ligament rupture after multiligament knee injuries have shown very favorable outcomes.

Hypothesis: Reconstruction of the posterior cruciate ligament by combining the tibial-inlay and two-femoral-tunnel techniques will result in improved stability and functional outcomes.

Study Design: Prospective cohort study.

Methods: Twenty-nine patients with 30 posterior cruciate ligament ruptures and multiligament knee injuries treated with the combined technique were evaluated with clinical, radiographic, and functional outcome measures.

Results: All patients had a clinical examination result indicating joint stability (0 or 1+) at an average follow-up of 25 months (range, 15 to 39). Twenty-three knees had no laxity, and seven had 1+ laxity. The KT-2000 arthrometer data documented less than 0.5 mm of side-to-side mean difference for both posterior displacement and total anterior-posterior displacement at both 30° and 70° of knee flexion. Knee range of motion was a mean extension of 1° (range, 0° to 10°) and a mean flexion of 124° (range, 75° to 145°). Mean Lysholm knee score was 89.4.

Conclusions: Reconstruction with a combination tibial-inlay and two-femoral-tunnel technique provides good results after multiligament knee injuries. All patients had a stable posterior cruciate ligament at most recent clinical follow-up, and 77% had no laxity at all.

To access the full text of this article, please click here.
There is no charge for viewing articles. However, a password is required.
If you do not already have a password, please e-mail Michael Frind at frind@execulink.com for one.
Prior to requesting a password, please make certain you have read the Site Terms of Use pertaining to this site.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Copyright American Journal of Sports Medicine, American Orthopaedic Society for Sports Medicine, March 2003. For details regarding copyright as it applies to this page, please visit the page entitled Site Terms of Use and Aspects of Copyright on this site.

This website was created for the benefit of the world's largest knee-injury community, Bob's ACL WWWBoard (also known as the Kneeboard), accessible to everyone at http://factotem.org.

Documents posted on this site serve merely as a virtual library, and are intended solely for purposes of making access to high-quality peer-reviewed medical-journal articles convenient for all users of the Kneeboard. Knee-injury patients are hereby encouraged to discuss this material with their respective medical teams.

Site Terms of Use and Aspects of Copyright

Printing Hints and Tips