Purpose: To compare the clinical and stress radiologic results of posterior cruciate ligament (PCL) reconstruction using the transtibial tunnel technique and tibial inlay technique.
Type of study: Retrospective case series.
Methods: Patients who had received isolated PCL reconstruction without combined ligamentous reconstruction and who also had a minimum 2-year follow-up were included in the study. The transtibial tunnel technique with quadrupled hamstring autograft group (group A) was composed of 21 knees and the tibial inlay technique with bone-patellar tendon-bone autograft group (group B) of 22 knees. We compared the 2 groups with regard to Lysholm knee scores, Tegner activity scores, posterior draw tests at 90 degrees flexion, and radiologic stability of the knees by using a Telos device (Austin & Associates, Fallston, MD).
Results: The Lysholm knee scores showed a significant improvement from 55.3 points preoperatively to 91.5 at the final follow-up in group A and from 51.7 preoperatively to 93.5 at the final follow-up in group B. However, intergroup differences were not significantly different (P = .259). Activity levels, as determined using the Tegner scoring system, also showed significant improvements at the final follow-up in both groups, but again, this was not significantly different (P = .264). On the posterior drawer test at the final follow-up, normal or grade I laxity was observed in 19 patients in group A and in 20 patients in group B. By instrumented posterior laxity testing, mean side-to-side differences were significantly improved from 12.3 mm preoperatively to 3.7 mm at the final follow-up in group A and from 11.0 mm to 3.3 mm in group B, but without significance (P = .607).
Conclusions: The transtibial tunnel and tibial inlay techniques produced relatively good clinical and stress radiologic results, and no significant differences were identified between the 2 techniques. Therefore, we suggest that the transtibial tunnel and tibial inlay techniques are both satisfactory PCL reconstruction procedures.
Level of evidence: Level III.