• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.97-104
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• 2000

Purpose : The majority of PCL deficient knees have some intact remnant PCL bundles. In these cases, the remnant PCL bundles were removed fur easy passage of graft(especially in bone-patellar tendon-bone graft). The purpose of study is to report the results of PCL reconstruction by posterior transseptal portal technique and by preserving the remnant posterior cruciate ligament bundles. Materials & Methods : From November 1993 to June 1999, 44 arthroscopic posterior cruciate ligament reconstructions have been performed by one surgeon. We studied 37 knees those were followed up over 1 year among them. The mean age($14\~56$ years) was 31.8 years. The average follow-up period was 17.8 months($12\~61$ months). The graft materials were 29 double-loop hamstring autografts, 4 double-loop hamstring allografts and 4 Achilles tendon-bone allograft. Results : There are significant improvement of the preoperative subjective symptoms. The last follow-up shows that the average Lysholm knee score was markedly improved from 59.8 pre-operation to 89.2 post-operation and the average KT 2000 side difference was decreased from 11.1mm pre-operation to 2.3 mm post-operation. Follow-up MRI showed that the graft was healed with remnant posterior cruciate ligament bundles as one ligament. Conclusion : The posterior trans-septal portal makes it possible to locate the exact tibial tunnel. The arthroscopic PCL reconstruction preserving the remnant of original PCL bundles seems to provide the good result.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.125-131
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• 2011

Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.537-546
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• 2019

Purpose: Anteromedial (AM), posterolateral (PL), anterior, and posterior remnant preserving anterior cruciate ligament (ACL) reconstructions were conducted on patients with partial ACL tears based on the arthroscopic findings. The clinical results of the four groups were compared. Materials and Methods: This study included 98 patients who underwent a remnant preserving ACL reconstruction from January 2013 to June 2016 and could be followed-up for at least two years. The subjects were categorized into four groups according to the selective bundles reconstructed: group A, anteromedial selective bundle reconstruction; group B, posterolateral selective bundle reconstruction; group C, anterior bundle reconstruction; and group D, posterior bundle reconstruction. The preoperative and postoperative anterior translation from the stress X-ray, International Knee Documentation Committee Subjective Knee Form (IKDC SKF) score, Lysholm score, and hospital for special surgery (HSS) score were compared. Results: All four groups showed significant improvement in anterior translation on the stress X-ray conducted with knees at 15° flexion, IKDC SKF score, Lysholm score, and HSS score postoperatively (in all groups, p<0.001). No intergroup differences were observed in terms of the functional outcomes except that preoperative IKDC SKF score was higher in the C group than in the A group (p=0.021), and the preoperative Lysholm score was higher in the B group than in the A group (p=0.03). Conclusion: After the AM, PL, anterior, and posterior remnant preserving ACL reconstructions, all four groups showed satisfactory results in terms of the anteroposterior stability and functional knee scores with no significant intergroup differences.