Abstract
For the new arthroscopic femoral tensioning and posterior cruciate ligament (PCL)
reconstruction in chronic PCL injury, we make a transtibial tunnel, using the posterior
trans-septal portal, while preserving the remnant bundle of the original PCL and meniscofemoral
ligament. Also, to preserve the remnant femoral fibers of the PCL and provide femoral
tensioning, we manipulate the suture hook with No.1 PDS by hand so that the sharp
tip penetrates the remnants of the PCL near the femoral attachment site. After pulling
the sutures previously placed at the remnant PCL fibers, the notchplasty osteotome
is advanced to the femoral footprint of the PCL to a depth of 1 to 2 mm from the shallow
to the deep direction. Then the remnant PCL fibers are detached from the medial femoral
condyle, which the authors call the artificial femoral “peel-off” tear. We drill the
femoral tunnel using the outside-in technique in the anatomic place of PCL footprint,
which is located 1 to 2 mm from the edge of the articular cartilage. This procedure
significantly contributes to the posterior stability and proprioception of the knee
joint, the remnant femoral fibers and meniscofemoral fibers are preserved to be healed
with a graft and subsequently form an integrated structure.
Key Words
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References
- The effect of posterior cruciate ligament reconstruction on patellofemoral contact pressures in the knee joint under simulated muscle loads.Am J Sports Med. 2004; 32: 109-115
- Arthroscopic posterior cruciate ligament reconstruction using the posterior trans-septal portal.Arthroscopy. 2003; 19: 101-107
- Magnetic resonance imaging of posterior cruciate ligament injuries.Am J Knee Surg. 1999; 12: 209-213
- Chronically injured posterior cruciate ligament.Clin Orthop. 1997; 335: 224-232
- Proprioception of the knee before and after anterior cruciate ligament reconstruction.Arthroscopy. 2003; 19: 2-12
- Reconstruction of the posterior cruciate ligament by the modified tibia inlay method.J Korean Knee Soc. 2001; 36: 549-554
- Posterior cruciate ligament reconstruction. An in vitro study of femoral and tibial graft placement.Am J Sports Med. 1996; 24: 437-445
- Quantitative analysis of human cruciate ligament insertions.Arthroscopy. 1999; 15: 741-749
Article info
Footnotes
Cite this article as: Ahn JH, Nha KW, Kim YC, Lim HC, Nam HW, Wang JH. Arthroscopic femoral tensioning and posterior cruciate ligament reconstruction in chronic posterior cruciate ligament injury. Arthroscopy 2006;22:341.e1-341.e4 [doi:10.1016/j.arthro.2005.11.011].
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Copyright
© 2006 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
