Posterior cruciate ligament reconstruction via
tibial inlay technique in multiligament
knee injuries
Correspondence: Sinan Zehir, MD. Hitit Üniversitesi Tıp Fakültesi, Ortopedi ve
Travmatoloji Anabilim Dalı, Bahçelievler Mah., Çamlık Cad., No: 2, 19030 Çorum, Turkey.
Tel: +90 364 – 222 11 00 e-mail: sinanzehir@yahoo.com
Submitted: November 24, 2014 Accepted: March 28, 2015
©2015 Turkish Association of Orthopaedics and Traumatology
Available online at
www.aott.org.tr
doi: 10.3944/AOTT.2015.14.0443
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Acta Orthop Traumatol Turc 2015;49(6):579–585
doi: 10.3944/AOTT.2015.14.0443
Sinan ZEHİR
1
, Nurzat ELMALI
2
, Ercan ŞAHİN
3
, Murat ÇALBIYIK
1
, Mustafa KARAKAPLAN
4
, Zeki TAŞDEMİR
2
1
Hitit University Faculty of Medicine, Department of Orthopaedics and Traumatology, Çorum, Turkey
2
Bezmi Alem Vakıf University, Department of Orthopaedics and Traumatology, İstanbul, Turkey
3
Bülent Ecevit University Faculty of Medicine, Department of Orthopedics and Traumatology, Zonguldak, Turkey
4
İnönü University Faculty of Medicine, Department of Orthopedics and Traumatology, Malatya, Turkey
Annual incidence of knee ligament injuries is reported to
be 60.9 per 100,000 people, with posterior cruciate liga-
ment (PCL) injuries being far less common than anterior
cruciate ligament (ACL) injuries.
[1,2]
Te PCL is referred
to as the “central pivot” of all of all other ligaments,
[3]
and
surgical reconstruction for PCL injuries remains con-
Objective: Te aim of this study is to report our institution’s experience regarding the use of open
tibial inlay technique in patients undergoing single-stage combined posterior cruciate ligament (PCL)
reconstruction.
Methods: Records of 17 patients who underwent PCL reconstruction with tibial inlay technique were
retrospectively reviewed. Patients with ipsilateral femoral or tibial osteochondral avulsion fractures or
ipsilateral concomitant tibia and femur shaft fractures were excluded. Out of these 17 patients, six cas-
es underwent anterior cruciate ligament (ACL) + PCL reconstruction, nine cases underwent ACL+
PCL + posterolateral corner reconstruction, one case underwent ACL + PCL + MCL reconstruction
and one case underwent ACL+ PCL + posterolateral corner + MCL reconstruction. Mean follow-up
was 14.27±6.77 (range: 6–30) months.
Results: In preoperative assessments, all patients had 3+ posterior laxity in posterior drawer test; at
fnal follow-up, 6 patients had 0 laxity, 7 patients had 1+ laxity, and 4 patients had 2+ laxity (p<0.001).
International Knee Documentation Committee (IKDC) objective evaluation showed severe disabil-
ity in all patients preoperatively, whereas 5 knees were grade A, 8 knees were grade B, 3 knees were
grade C, and 1 knee was grade D at fnal follow-up. Mean IKDC subjective score was 75.22±7.53
at fnal follow-up. Postoperatively, mean side-to-side diference in KT-1000 arthrometer measure-
ment was 2.45±1.80 mm. At fnal follow-up, mean range of motion (ROM) was 0º on extension and
123.56±6.31º on fexion.
Conclusion: Open tibial inlay approach is benefcial during PCL reconstruction. Further study is war-
ranted to establish its efectiveness on functional outcomes and prevention of complications.
Keywords: Knee ligament injury; posterior cruciate ligament; tibial inlay.
Level of Evidence: Level IV Terapeutic Study
ORIGINAL ARTICLE