Arthroscopic Standard Anterior and Posteromedial Portal Posterior Cruciate Ligament Reconstruction With Remnant Preservation: 2-Year Follow-up



Sholahuddin Rhatomy1, 2, *, Erwin Saspraditya3, Riky Setyawan2, 3
1 Sport and Adult Reconstructive Division, Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia
2 Soeradji Tirtonegoro Sport Center and Research Unit, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia
3 Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Abstract

Background:

Grade 3 Posterior Cruciate Ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of the preservation of PCL remnant with achieving good visualization. The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-years follow-up.

Methods:

We conducted a cohort retrospective study between January 2013 to December 2015. In this study, 25 patients underwent PCL reconstruction using standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm knee score, Modified Cincinnati Score, and Knee Society Score (KSS) at pre-operative and 2-years post-operative. Range of Motion (ROM) and complication were evaluated post-operatively.

Results:

The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p<0.05). The average Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The International Knee Documentation Committee (IKDC) score improved from 60.50 ± 15.10 to 95.60 ± 3.44. The Modified Cincinnati Score improved from 62. 28 ± 13.6 to 96,04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. 22 patients had 0-135° full ROM and 3 patients had 0-110° ROM. Two patients had surgical site infection but recovered with local debridement.

Conclusion:

PCL reconstruction using standard anterior and posteromedial portal with remnant preservation at 2 years follow up resulted in satisfactory clinical and functional outcomes.

Keywords: Posterior cruciate ligament, Posterior cruciate ligament reconstruction, Remnant preservation, Functional outcome score, Posteromedial portal.


Abstract Information


Identifiers and Pagination:

Year: 2019
Volume: 12
Publisher Item Identifier: EA-TOSSJ-2019-10

Article History:

Received Date: 01/08/2019
Revision Received Date: 18/09/2019
Acceptance Date: 21/09/2019
Electronic publication date: 25/10/2019
Collection year: 2019

© 2019 Rhatomy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Sport and Adult Reconstruction Division, Orthopaedics and Traumatology Department, Soeradji Tirtonegoro Hospital, Indonesia; Tel: +62272-321163; Fax: +62272-321104;
E-mail: doktergustomrhatomy@yahoo.com