J Korean Orthop Assoc.  2011 Oct;46(5):419-425.

A Clinical and Radiographic Comparison of Anteromedial and Anterolateral Trans-tibial PCL Reconstruction

• Lee DC
• Shon OJ
• Park CH
• Ko YJ

Abstract

PURPOSE
The purpose of this clinical study was to compare the outcomes of anteromedial and anterolateral trans-tibial approachs in arthroscopic PCL reconstruction.
MATERIALS AND METHODS
Between January 2004 and December 2007, 40 patients (40 knees, which underwent PCL reconstruction, with a follow-up of more than 1.6 years) were surveyed in the areas of clinical and radiographic results and individual satisfaction. Forty knees with isolated PCL rupture were reviewed retrospectively. They were divided into two groups of equal size according to the transtibial approach used: anteromedial or anterolateral. The evaluation parameters included activities and functional outcomes using the Lysholm and Tegner score, single leg hop test and individual satisfaction using the IKDC score. Radiographic results were analyzed using the posterior drawer radiography with manual methods and the Telos device, and the changes in the tibial tunnel diameter were measured.
RESULTS
Both groups showed improvements in the Lysholm and Tegner score. Both groups showed improvements in the single leg hop test. As far as individual satisfaction evaluation using the IKDC score was concerned, 85% of cases in both groups improved to nearly normal. Both groups showed improvements on the posterior drawer radiography. Tibial tunnel enlargement was also seen. The results of both groups demonstrated no statistically significant difference.
CONCLUSION
Both groups showed improvements in the clinical and radiographic results and in the individual satisfaction score. However, results of both groups demonstrated no statistically significant difference. Therefore, the long term results need to be studied.

Keyword

anteromedial; anterolateral; tibia tunnel; PCL reconstruction

MeSH Terms

Follow-Up Studies
Humans
Humulus
Knee
Leg
Retrospective Studies
Rupture

Figure

• 

  Figure 1 Schematic diagrams of the knee in anteroposterior projection (A) and lateral projection (B) show anteromedial trans-tibia approach in AM and anterolateral approach in AL. Starting point of the tibial tunnel is 15 mm medially away from the tibial tuberosity in AM and 20 mm laterally away from the tibial tuberosity. The tunnel is made as 45° angle with respect to the joint line in AM and 50° angle with respect to the joint line in AL.

• 

  Figure 2 Postoperative radiographs of anteromedial (A) and anterolateral (B) transtibial PCL reconstruction.

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