J Korean Orthop Assoc.  2016 Apr;51(2):165-172. 10.4055/jkoa.2016.51.2.165.

Comparison of Clinical and Radiological Results between Posteromedial Portal Technique and Posterior Transseptal Portal Technique in Making a Tibial Tunnel in Single Bundle Posterior Cruciate Ligament Reconstruction with Remnant Preservation

Affiliations
  • 1Department of Orthopedic Surgery, Gachon University School of Medicine, Incheon, Korea. bklee@gilhospital.com

Abstract

PURPOSE
The purpose of this study is to compare the clinical and radiological results between posteromedial portal technique and posterior transseptal portal technique in making a tibial tunnel in single bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation.
MATERIALS AND METHODS
Thirty-three cases of posteromedial portal technique and 35 cases of posterior transseptal portal technique in making a tibial tunnel in single bundle PCL reconstruction with remnant preservation were evaluated retrospectively. The clinical evaluation, including function and stability, was assessed. The tibial tunnel placement was measured using computed tomography.
RESULTS
At final follow-up, the clinical results showed significant improvement compared to preoperation in both groups. There were no significant differences in clinical results including function and stability in both groups. The centers of tibial tunnels by posteromedial portal technique were placed more medially and proximally than those of the posterior transseptal portal technique.
CONCLUSION
Remnant preserved single bundle PCL reconstructions by posteromedial portal technique and posterior transseptal portal technique were good methods for restoring function and stability compared to preoperation. There were no significant differences in clinical results in both groups. However, the tibial tunnels by posteromedial portal technique tended to be more medial and proximal placements than those of the posterior transseptal portal technique.

Keyword

posterior cruciate ligament; reconstruction; posteromedial portal technique; posterior transseptal portal technique

MeSH Terms

Follow-Up Studies
Posterior Cruciate Ligament*
Retrospective Studies

Figure

  • Figure 1 Guide pin placement in arthroscopy (white arrows: guide pin, black arrows: preserved remnant). (A) Posteromedial portal technique. (B) Posterior transseptal portal technique.

  • Figure 2 Evaluation of tibial tunnel placement in the coronal plane.

  • Figure 3 Evaluation of tibial tunnel placement in the sagittal plane.

  • Figure 4 The center of tibial tunnel placement in the coronal plane (white dot: the center of the tibial tunnel by posteromedial portal technique, black dot: the center of the tibial tunnel by transseptal portal technique, x: reference point, 48%15)).

  • Figure 5 The center of tibial tunnel placement in the sagittal plane (white dot: the center of the tibial tunnel by posteromedial portal technique, black dot: the center of the tibial tunnel by transseptal portal technique, x: reference point, 25%15)).


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