Accessory anterolateral portal in arthroscopic PCL reconstruction

作者：Lee Gun Woo; Jang Soo Jin; Choi Young; Son Jung Hwan^*

来源：Knee Surgery, Sports Traumatology, Arthroscopy, 2013, 21(5): 1043-1049.

DOI：10.1007/s00167-012-2130-3

• Knee
• Posterior cruciate ligament
• Femoral tunnel
• Accessory anterolateral portal

To evaluate the clinical and radiological results of arthroscopic PCL reconstruction using an accessory anterolateral portal for femoral tunneling and to compare these results with those of the conventional technique.
We retrospectively reviewed the clinical and radiological results for 57 patients who underwent PCL reconstruction, including 31 patients who underwent arthroscopic PCL reconstruction with an accessory anterolateral portal (group A) and 26 patients who underwent conventional arthroscopic PCL reconstruction (group B). Lysholm score, IKDC score, simple radiographs (AP and lateral), and posterior drawer test results were evaluated preoperatively and at 3 years postoperatively.
No major complication was observed in group A. However, posterior cortical disruption due to improper placement of the femoral tunnel was observed in one patient in group B. The mean Lysholm knee scores increased from 41.5 +/- A 4.8 preoperatively to 92.5 +/- A 6.2 at final follow-up in group A (P < 0.001), and from 43.5 +/- A 3.4 preoperatively to 88.5 points +/- A 3.7 in group B (P = 0.002). Posterior stress radiographs with a KT-1000 showed that the mean side-to-side differences improved from 13.79 +/- A 5.1 mm preoperatively to 3.1 +/- A 0.7 mm postoperatively in group A and from 12.68 +/- A 6.3 mm preoperatively to 3.5 +/- A 0.5 mm postoperatively in group B. The sensitivity and specificity of the placement and direction of the femoral tunnel were significantly higher in group A than group B (P = 0.002).
Arthroscopic PCL reconstruction with an accessory anterolateral portal can provide a better surgical view than the conventional technique, and this can minimize the problems associated with femoral tunneling, such as inappropriate and inconsistent placement of the tunnel, abnormal angulation, and sliding of the guide tip. Moreover, this approach may have a shorter operative time and a better functional recovery than the conventional technique.
Retrospective comparative study, Level IV.

• 出版日期2013-5