Modified arthroscopic technique to replace the posterior cruciate ligament in multiligament knee injuries Results compared to open tibial inlay technique

Background There is no standard procedure regarding surgical treatment of multiligament knee injuries involving rupture of the posterior cruciate ligament. Objective Does the modified and purely arthroscopic operation technique show similarly good results compared to the familiar open tibial inlay technique? Methods A total of four patients were surgically treated using the open tibial inlay technique (group A) and seven using the modified arthroscopic approach (group B). The prospectively designed follow-up examination comprised the Lysholm score, the subjective questionnaire of the International Knee Documentation Committee (IKDC) score as well as the specifically extended Orthopedic Working Group Knee (OAK) score for clinical assessment. Tests on translational movability of the knee joint were performed with the Rolimeter (R). The level of statistical significance alpha was set at 5%. Results The follow-up examination took place on average 28.5 +/- 19.60 months and 30.6 +/- 26.26 months postoperatively in groups A and B, respectively. Groups A and B recorded mean 70.3 +/- 5.32 and 69.6 +/- 19.82 points in the Lysholm score, respectively. In the subjective IKDC score group A showed 67.3 +/- 7.76 points and group B 65.9 +/- 12.35 points. The OAK score was 77.5 +/- 6.10 points in group A and 75.3 +/- 11.31 points in group B. The side difference in the posterior drawer test was 1.75 +/- 1.192mm in group A and 2.50 +/- 2.160mm in group B. In the reverse Lachman test differences of 2.37 +/- 2.175mm and 3.22 +/- 2.059mm were measured in groups A and B, respectively. All values showed no significant differences between the two evaluated groups. Conclusion The results of the two operation techniques were not significantly different. The arthroscopic approach is therefore regarded as the preferred method in this institute.