Tibial Onlay Posterior Cruciate Ligament Reconstruction: Surgical Technique and Results

Rodrigo Salim; Felipe Marques do Nascimento; Aline Miranda Ferreira; Luciano Fonseca Lemos de Oliveira; Fabricio Fogagnolo; Mauricio Kfuri

doi:10.1055/s-0037-1603336

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2018; 31(03): 284-290
DOI: 10.1055/s-0037-1603336

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tibial Onlay Posterior Cruciate Ligament Reconstruction: Surgical Technique and Results

Authors

Rodrigo Salim

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil
Felipe Marques do Nascimento

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil
Aline Miranda Ferreira

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil
Luciano Fonseca Lemos de Oliveira

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil
Fabricio Fogagnolo

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil
Mauricio Kfuri

¹Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo–USP, Brazil

²Department of Orthopedics, University of Missouri, Columbia, Missouri

Abstract

The posterior cruciate ligament (PCL) is a fundamental structure in knee kinematics. PCL tears may lead to adverse consequences, such as impaired functional performance and an increased risk of osteoarthritis. Although surgical treatment is a well-established option for the patients of PCL rupture, many surgeons opt for conservative treatment because of the lack of consensus in the orthopedic literature concerning the best surgical method with less risk of iatrogenic lesions to the neurovascular structures in the popliteal region. Here, we describe an onlay technique for PCL reconstruction, which has some advantages over the traditional transtibial and over inlay techniques. The technique described in this study avoids the “killer angle”—frequently considered the cause of laxity of the reconstructed ligament—while simultaneously permitting safe retraction of the neurovascular structures without the need for a change in the patient's position. This technique has been used at our institution for approximately 10 years with very satisfactory results. The aim of this study is to describe the technique and perform a retrospective evaluation of the results of a case series.

Keywords

posterior cruciate ligament - ligament reconstruction - onlay

Full Text

References

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