Abstract:

BACKGROUND: The reconstruction of posterior cruciate ligament (PCL) by tibial tunnel method is limited in treating PCL tear with concomitant ipsilateral tibial shaft fracture which is operated by internal fixation firstly, because there is the internal fixation in the proximal tibia, which can interfere with the making of tibial tunnel.
OBJECTIVE: To evaluate the Tibial-inlay technique effects on reconstruction of PCL combined with concomitant ipsilateral tibial shaft fracture.
METHODS: Eight knees with PCL tear and concomitant ipsilateral tibial shaft fracture in 8 patients were verified with physical examination, medical image and arthroscopy. All the damaged PCLs were reconstructed with allograft tendons by Tibial-inlay technique under arthroscopy 1-6 months after the first internal fixation. The instability degree of post draw test and the Lysholm score of the knees were recorded before operations and at follow-up.
RESULTS AND CONCLUSION: All of them were followed up for 12 to 24 months. The tibial retropositions of 5 cases were from 10 mm to 15 mm, and those of 3 cases were more than 15 mm before reconstructions. The tibial retropositions of 6 cases were no more than 5 mm, and those of 2 cases were from 5 mm to 10 mm at the final follow-up. The Lysholm score was remarkably improved from 63.50±5.83 preoperatively to 87.50±2.33 at follow-up (P < 0.05). The reconstruction of PCL by Tibial-inlay technique, with regard to PCL tear and concomitant ipsilateral tibial shaft fracture, has advantages of non-limitation by tunnel of proximal tibia, no interference to internal fixation of tibia and reliable satisfactory outcome.