No Clinically Important Difference in Knee Scores or Instability Between Transtibial and Inlay Techniques for PCL Reconstruction: A Systematic Review

Shin, Yang Sik; Kim, Hyun-Jung; Lee, Dae-Hee

doi:10.1007/s11999-016-5176-6

Cited by 40 publications

(45 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is interesting to note that Lee et al 12 show promising results among elite athletes with this single-bundle allograft PCL reconstruction technique. Although their primary outcomes (Lysholm score, 89.4) are not measurably different from those previously reported after traditional PCL reconstruction, 9 their 86% rate of return to preinjury sports significantly deviates from the more bleak rate of 44% described by a recent meta-analysis. 15 However, patient selection, lack of associated injuries, dynamic brace use, 16 and time to surgery may play a much larger role than a subtle variation in surgical technique.…”

Section: See Related Article On Page 2658contrasting

confidence: 61%

“…[6][7][8] However, despite these advances, clinical outcome data have failed to show clinically meaningful differences in patient-reported measures or more favorable rates of return to high-demand sporting activity. [9][10][11] Lee, Kim, Yang, and Cho 12 from the Republic of Korea, in their 52-patient case series titled "Return to Sports and Clinical Outcomes After Arthroscopic Anatomic Posterior Cruciate Ligament Reconstruction With Remnant Preservation," have eloquently advocated a remnant-sparing technique in isolated grade III PCL injuries. In contrast to other authors who have suggested exposure of the "champagne glass drop off" point is necessary, 13 Lee et al 12 use a trans-septal approach to detach the posterior capsule from the PCL while preserving a generous distal stump of the PCL for anatomic guidance during tunnel placement.…”

Section: See Related Article On Page 2658mentioning

confidence: 99%

See 1 more Smart Citation

Editorial Commentary: Stump Sparing or Footprint Exposing? Management of the Tibial Remnant During Posterior Cruciate Ligament Reconstruction

Jarvis

Waterman²

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Surgical management of an isolated grade III posterior cruciate ligament tear has been enveloped in debate since the first reconstruction technique report was written by Hey Groves in 1919. With the evolution of arthroscopy, party lines have been drawn over tibial inlay versus transtibial techniques, as well as single-versus double-bundle techniques. More subtle controversy exists regarding autograft versus allograft, outside-in versus inside-out drilling, and treatment of the tibial footprint of the posterior cruciate ligament. New remnant-sparing techniques, using a transseptal posterior portal, may augment biology, maintain better proprioception, and mitigate abrasive wear at the "killer turn." However, longer-term comparative studies will be necessary to determine the existence of any clinically significant improvement in outcome.

show abstract

Section: See Related Article On Page 2658contrasting

confidence: 61%

Section: See Related Article On Page 2658mentioning

confidence: 99%

Editorial Commentary: Stump Sparing or Footprint Exposing? Management of the Tibial Remnant During Posterior Cruciate Ligament Reconstruction

Jarvis

Waterman²

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

show abstract

“…As stated above, studies have not found a clinical difference between the transtibial or inlay procedures. [63][64][65] The arthroscopic inlay technique begins with drilling of the tibial tunnel. The ACL tunnel is drilled first and cannulas are placed in the posterior working portals to visualize the PCL recess.…”

Section: Surgical Techniquementioning

confidence: 99%

Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee

Kew

Miller

2020

J Knee Surg

View full text Add to dashboard Cite

Multiligamentous knee injuries are challenging to treat and diagnose. Posterior cruciate ligament (PCL) injuries are commonly found in the constellation of injuries included in a multiligamentous knee injury and are caused by a posteriorly directed force on the proximal tibia with relation to the femoral condyles. A thorough history and physical examination should be performed to evaluate for associated neurovascular injuries and associated ligamentous, chondral, or bony injuries. Nonsurgical management is reserved for patients who are critically ill or have very low activity demands. Surgical reconstruction is recommended for most patients with multiligamentous knee injuries. The PCL reconstruction can be undertaken with several different graft options and reconstruction techniques, including the transtibial, arthroscopic tibial inlay, and open tibial inlay approach. The literature has a paucity of data regarding outcomes among the various reconstructive options, so the optimal surgical technique has not been established.

show abstract

“…At this point, the surgeon can proceed with transtibial or inlay technique. Shin et al in a systematic review found no clinical differences between transtibial and inlay in regard to knee scores and stability [10]. Either technique can be used for revision but the surgeon should take into account the previous technique used at the time of the primary PCL reconstruction and the tunnel positions [11].…”

Section: Revision Pcl Techniquesmentioning

confidence: 99%

Revision PCL Reconstruction Review/Update

Gill

Gwathmey

2018

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Specifically, it is paramount to consider and treat posteromedial and posterolateral instability. Success in revision surgery focuses on appropriate graft choice and precise tunnel placement at anatomical attachment sites. Furthermore, correct tensioning of the graft, secondary or backup fixation and well-designed PT and rehab protocols are integral components. The factors causing failure of the primary reconstruction should be identified, as revision surgery must address the errors and follow strict surgical principals to be successful. There are many variables that play a role in successful revision posterior cruciate ligament (PCL) reconstruction. In general, as in most ligament reconstruction surgery, it is important to identify and address all associated pathology such as lower extremity malalignment and additional instability.

show abstract

No Clinically Important Difference in Knee Scores or Instability Between Transtibial and Inlay Techniques for PCL Reconstruction: A Systematic Review

Abstract: Level III, therapeutic study.

Cited by 40 publications

References 27 publications

Editorial Commentary: Stump Sparing or Footprint Exposing? Management of the Tibial Remnant During Posterior Cruciate Ligament Reconstruction

Editorial Commentary: Stump Sparing or Footprint Exposing? Management of the Tibial Remnant During Posterior Cruciate Ligament Reconstruction

Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee

Revision PCL Reconstruction Review/Update

Contact Info

Product

Resources

About