Anatomic reconstruction of the posterior cruciate ligament after multiligament knee injuries. A combination of the tibial-inlay and two-femoral-tunnel techniques.

Abstract

Neither operative nor nonoperative treatment of posterior cruciate ligament rupture after multiligament knee injuries have shown very favorable outcomes. Reconstruction of the posterior cruciate ligament by combining the tibial-inlay and two-femoral-tunnel techniques will result in improved stability and functional outcomes. Prospective cohort study. Twenty-nine patients with 30 posterior cruciate ligament ruptures and multiligament knee injuries treated with the combined technique were evaluated with clinical, radiographic, and functional outcome measures. All patients had a clinical examination result indicating joint stability (0 or 1+) at an average follow-up of 25 months (range, 15 to 39). Twenty-three knees had no laxity, and seven had 1+ laxity. The KT-2000 arthrometer data documented less than 0.5 mm of side-to-side mean difference for both posterior displacement and total anterior-posterior displacement at both 30 degrees and 70 degrees of knee flexion. Knee range of motion was a mean extension of 1 degrees (range, 0 degrees to 10 degrees ) and a mean flexion of 124 degrees (range, 75 degrees to 145 degrees ). Mean Lysholm knee score was 89.4. Reconstruction with a combination tibial-inlay and two-femoral-tunnel technique provides good results after multiligament knee injuries. All patients had a stable posterior cruciate ligament at most recent clinical follow-up, and 77% had no laxity at all.