Tibial tunnel placement in posterior cruciate ligament reconstruction: a systematic review.

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Serval ID
serval:BIB_EE6FCFA9B1C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Tibial tunnel placement in posterior cruciate ligament reconstruction: a systematic review.
Journal
Knee Surgery, Sports Traumatology, Arthroscopy
Author(s)
Nicodeme J.D., Löcherbach C., Jolles B.M.
ISSN
1433-7347 (Electronic)
ISSN-L
0942-2056
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
22
Number
7
Pages
1556-1562
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
PURPOSE: Reconstruction of the posterior cruciate ligament (PCL) yields less satisfying results than anterior cruciate ligament reconstruction with respect to laxity control. Accurate tibial tunnel placement is crucial for successful PCL reconstruction using arthroscopic tibial tunnel techniques. A discrepancy between anatomical studies of the tibial PCL insertion site and surgical recommendations for tibial tunnel placement remains. The objective of this study was to identify the optimal placement of the tibial tunnel in PCL reconstruction based on clinical studies.
METHODS: In a systematic review of the literature, MEDLINE, EMBASE, Cochrane Review, and Cochrane Central Register of Controlled Trials were screened for articles about PCL reconstruction from January 1990 to September 2011. Clinical trials comparing at least two PCL reconstruction techniques were extracted and independently analysed by each author. Only studies comparing different tibial tunnel placements in the retrospinal area were included.
RESULTS: This systematic review found no comparative clinical trial for tibial tunnel placement in PCL reconstruction. Several anatomical, radiological, and biomechanical studies have described the tibial insertion sites of the native PCL and have led to recommendations for placement of the tibial tunnel outlet in the retrospinal area. However, surgical recommendations and the results of morphological studies are often contradictory.
CONCLUSIONS: Reliable anatomical landmarks for tunnel placement are lacking. Future randomized controlled trials could compare precisely defined tibial tunnel placements in PCL reconstruction, which would require an established mapping of the retrospinal area of the tibial plateau with defined anatomical and radiological landmarks.
Pubmed
Web of science
Open Access
Yes
Create date
05/08/2014 17:45
Last modification date
20/08/2019 16:15
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