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

Abstract

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 trans-septal 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.