The 'Other' Cruciate Ligament: Newer Treatments for... (treat Grade 3 injuries: ...)

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The 'Other' Cruciate Ligament: Newer Treatments for PCL Tears

Date:7/1/2009

treat Grade 3 injuries:

Traditional: One-bundle bone graft passed through a tunnel in the tibia (shin bone). One-bundle grafts are made thicker than two-bundle grafts, but may not be as effective because they attach at a single point.
Newer: Two-bundle graft (studied for the past 10 years). Two-bundle grafts use thinner individual grafts, but their total graft volume is thicker. They may be more effective than one-bundle grafts because they attach at two different points.
Newer: Inlay reconstruction is an approach whereby a graft is screwed into the back of the tibia avoiding a tunnel through the front of the tibia.

According to Dr. Matava, basic science data suggests that it is favorable to use a two-bundle graft over a one-bundle graft, and that an inlay reconstruction is preferable to a graft passing through a tibial tunnel. Inlay reconstruction is different, he says, because the graft does not get stretched around the tibial tunnel and is prevented from stretching out and/or fraying.

"I like this procedure because I have had improved results compared to prior patients of mine that underwent the traditional method with the graft placed through the tibial tunnel," said Dr. Matava. "Additionally, there is biomechanical evidence that the benefits I have noticed are real." There have not been any randomized prospective studies to date, however, comparing the two methods.

Some orthopaedic surgeons, however, believe these procedures are more complicated and therefore more risky; they also disagree on how much tension to use on the graft. If a patient has a PCL injury, the orthopaedic surgeon should first determine the level of injury in order to decide on the best treatment option. Because PCL surgery is technically challenging, a patient needing surgery should seek out an orthopaedic surgeon with experien
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SOURCE American Academy of Orthopaedic Surgeons
Copyright©2009 PR Newswire.
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