Posterior cruciate ligament tibial inlay reconstruction

Is the All-arthroscopic Tibial Inlay Double-bundle PCL Reconstruction a Viable Option in Multiligament Knee Injuries?

“…In conclusion, there are multiple documented benefits of the proposed all-arthroscopic tibial inlay DB PCL reconstruction surgical technique: the likely avoidance of graft laxity and fatigue failure as a result of the killer turn, circumvention of an open dissection adjacent to vital neurovascular structures, and a kinematic profile more closely resembling the native PCL [1,3,8,9,14,15,21,22,34,37,38,42,45,52,58]. In the current study, when comparing similar injury patterns and severity, the allarthroscopic tibial inlay DB PCL reconstruction had generally equivalent clinical, functional, and radiographic results compared with previously described PCL reconstruction techniques.…”

“…Although some clinical studies have not found a difference between the transtibial and open inlay techniques [2,29], there is also a body of literature to suggest unsatisfactory results with residual laxity given the transtibial technique [10,21,25,53]. The tibial inlay PCL reconstruction technique was first introduced in 1995 to circumvent the killer turn of the conventional transtibial technique [3]. The inlay technique has subsequently evolved into an all-arthroscopic procedure, the major advantage of which is the elimination of open dissection adjacent to the popliteal neurovascular structures [20,58].…”

Posterior Cruciate Ligament Tibial Insertion Anatomy and Implications for Tibial Tunnel Placement

“…4 Furthermore, for the tibial tunnel in the PCL, the focus has been to prevent the killerturn effect and neurovascular injury. [5][6][7][8] The posterior aspect of the proximal tibia has a unique 3-dimensional anatomy compared with the mid or distal tibia, because multiple structures change abruptly, including the tibial plateau, posterior intercondylar fossa, and posterior cortex. The PCL inserts to the sloping central depression between the medial and lateral portions of the tibial plateau, and this insertion is distinct from the vertical cortex of the tibia (Fig 1A and 1B).…”

All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique

“…The specialized tibial guide allows reliable placement in the true tibial PCL footprint while maintaining a sufficient angle to eliminate the "killer turn." 5 The guide was designed with a curve that anatomically matches the approach necessary to avoid an intact ACL. In addition, the guide's design supplies an additional neurovascular shield during reaming.…”