Tibial Inlay Posterior Cruciate Ligament Reconstruction

Background: Posterior Cruciate Ligament (PCL) injuries, although less common than Anterior Cruciate Ligament (ACL) injuries, can significantly disrupt knee stability and function. Traditional surgical techniques for PCL reconstruction, particularly the transtibial tunnel method, are associated with complications such as graft wear and elongation due to the acute flexion angle at the tibial tunnel entrance, known as the 'killer rotation.' The inlay technique has emerged as an alternative approach aimed at addressing these issues by allowing for a more direct visualization of the PCL insertion site and minimizing graft tension. This study examines the methodology and outcomes of inlay PCL reconstruction, highlighting its advantages and considerations. Methods: The authors conducted a systematic review of the existing literature on the inlay tibia technique for PCL reconstruction up to ۲۰۲۰. They analyzed various studies focusing on surgical approaches, anatomical considerations, and biomechanical outcomes related to this method. This study emphasized the importance of precise graft placement to effectively replicate the native anatomy of the PCL. The inlay tibia method involves a posterior approach to access the knee joint, allowing surgeons to create femoral tunnels accurately and place the graft anatomically. The review also included a comparison of outcomes between the inlay technique and traditional methods, evaluating factors such as knee stability, range of motion, and complication rates. Results: The results indicate that inlay PCL reconstruction offers several advantages over traditional transtibial techniques, providing a means for more accurate graft placement that can reduce complications related to graft flexion angles and improve overall knee stability. The direct visualization afforded by the posterior approach enhances anatomical precision during surgery, leading to better functional outcomes post-operation. Furthermore, patients undergoing inlay tibia reconstruction reported higher satisfaction scores regarding knee function compared to those receiving traditional reconstructions. The complication rate was also lower with this technique, particularly regarding neurovascular injuries and graft failure. However, some challenges remain, including increased surgical time and the need for precise patient positioning during the procedure. Conclusion: Inlay reconstruction of the posterior cruciate ligament offers a promising alternative to traditional transtibial techniques with improved anatomical precision and reduced complications related to graft tension. The ability for direct visualization of the PCL insertion site enhances surgical outcomes and patient satisfaction. As further research continues to refine this technique, it is essential for surgeons to weigh the benefits against potential challenges, such as increased operation time and complexity.

کلیدواژه ها:

Posterior cruciate ligament ، PCL reconstruction ، Tibial inlay technique ، Knee stability ، Graft placement ، Surgical outcomes