Remnant‐Preserving Posterior Cruciate Ligament Reconstruction Over Remnant Fibers Using a Figure‐of‐Four Position and a Posterior Trans‐Septal Portal. Issue 6 (30th September 2020)

• Record Type: Journal Article
• Authors: Xiong, Yi‐lin; Su, Chao; Kuang, Shi‐da; Zhao, Xin; Li, Yu‐sheng; Xiao, Wen‐feng; Zhu, He‐yuan; Liu, Wei‐jie; Gao, Shu‐guang
• Is Part Of: Orthopaedic surgery. Volume 12:Issue 6(2020)
• Page Start: 2018
• Page End: 2025
• Publication Date: 2020-09-30
• Subjects: Arthroscopy -- Posterior cruciate ligament -- Reconstruction -- Remnant preservation; Orthopedic surgery -- Periodicals; Orthopedics -- Periodicals; Musculoskeletal system -- Wounds and injuries -- Periodicals; 617.47005
• DOI: 10.1111/os.12755
• Languages: English
• ISSNs: 1757-7853

Abstract

Abstract : Anatomic tunnel formation and remnant preservation are the recent trends in posterior cruciate ligament (PCL) reconstruction. However, it is difficult to observe the anatomical PCL footprint and perform the operation in the process of remnant‐preserving PCL reconstruction. This study describes a single‐bundle, transtibial PCL reconstruction technique with anatomic graft passage over the remnant PCL fibers. A femoral tunnel of PCL is created at 2 mm medial to the roof of the intercondylar notch and 3 mm proximal to the margin of the articular cartilage. The tibial insertion of PCL is observed using a figure‐of‐four position through a posterior trans‐septal portal. A tibial bone tunnel is made below the distal center portion of the tibial insertion of residual PCL fibers. The graft is passed over the PCL through the tibial bone tunnel, the space between the anterior cruciate ligament (ACL) and the residual PCL fibers, to the femoral socket and is fixed by the EndoButton and screw. This technique is able to ensure a reasonable intra‐articular length and optimal isometry. It has been applied in patients with PCL rupture and posterior instability of the knee joint, and no intraoperative or postoperative complications occurred. Our technology provides a valuable new treatment option for PCL rupture. Future comparative studies are needed to further clarify its beneficial effect.