0
Scientific Articles   |    
Revision Posterior Cruciate Ligament Reconstruction with a Modified Tibial-Inlay Double-Bundle Technique
Sang Hak Lee, MD1; Young-Bok Jung, MD2; Sung-Min Rhee, MD3; Han-Jun Lee, MD3; Ho-Joong Jung, MD3
1 Center for Joint Diseases and Rheumatism, Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, South Korea
2 Joint Center, Department of Orthopaedic Surgery, Hyundae General Hospital, 663 Jang hyeon-ri, Jinjeop-eup, Namyangju-si, Gyeonggi-do 472-865, South Korea. E-mail address: jungyb2000@paran.com
3 Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, 224-1, Heukseok-dong, Dongjak-ku, Seoul 140-757, South Korea
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Based on an original article: J Bone Joint Surg Am. 2012 Mar 21;94(6):516-22.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2014 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2014 Jan 08;4(1):e1 1-6. doi: 10.2106/JBJS.ST.M.00059
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

Overview
Introduction

We present the surgical technique for arthroscopic revision posterior cruciate ligament (PCL) reconstruction with use of the modified tibial-inlay double-bundle method without a change of the patient’s position from supine to prone.

Step 1: Graft Preparation

Create the Achilles tendon allograft as a tibial bone block with two femoral bundles.

Step 2: Patient Position

With the patient in the supine position, flexion, abduction, and external rotation of the hip and flexion of the knee 60° to 90° can provide easier access to the popliteal area.

Step 3: Femoral Tunnel Preparation

Make anterolateral and posteromedial femoral tunnels in a shallow-shallow position using an outside-in technique for the anterolateral bundle and the inside-out technique for the posteromedial bundle.

Step 4: Tibial Tunnel Preparation

Make the tibial tunnel with the patient supine with the hip flexed, abducted, and externally rotated and the knee flexed 60° to 90° to provide easier access to the popliteal area.

Step 5: Graft Passage

Using a wire loop, pass the graft through the knee joint posterior to the intercondylar notch into the femoral tunnel.

Step 6: Graft Fixation

Use a cannulated screw with a spiked washer to secure fixation of the bone block to the tibia.

Step 7: Postoperative Rehabilitation

Rehabilitation after a PCL repair is generally more conservative than the accelerated rehabilitation used after an ACL repair.

Results

In our study, twenty-two patients (twenty men and two women; mean age, 37.4 years) were treated with revision PCL reconstruction performed with the described technique and followed for a mean of 39.6 months (range, twenty-four to seventy-two months)14.

Indications

Contraindications

Pitfalls & Challenges

Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Essential Surgical Techniques?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    Results
    Provided by:
    Essential Surgical Techniques
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    01/08/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    01/22/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    04/16/2014
    Ohio - OhioHealth Research and Innovation Institute (OHRI)
    02/05/2014
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research