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Variation in Graft Bending Angle during Range of Motion after Suspensory Femoral Fixation in Posterior Cruciate Ligament Reconstruction: Inside-out technique versus Retro-socket Outside-in technique
Author(s):
Kang B. (South Korea (ROK))
Kang B. (South Korea (ROK))
Affiliations:
ESSKA Academy. Kang B. 05/09/18; 209797; P17-506 Topic: Arthroscopic Surgery
Byungmin Kang
Byungmin Kang
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Abstract
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Objectives: Greater variation in femoral graft bending angle during range of motion (ROM) of the knee can result in graft loosening and failure in posterior cruciate ligament (PCL) reconstruction. To compare variation in femoral graft bending angle during ROM between inside-out (IO) and retro-socket outside-in (OI) techniques for suspensory femoral fixation in PCL reconstruction using in vivo 3D-computed tomography(CT) analysis. It was hypothesized that the retro-socket OI technique would produce less variation in femoral graft bending angle during ROM of the knee than the IO technique.

Methods: Ten patients underwent PCL reconstruction by IO technique (5 patients) or retro-socket OI technique (5 patients) for suspensory femoral fixation. After PCL reconstruction, 3D-CT was taken in knee extension and 90° flexion positions to reconstruct 3D femur and tibia bone models using Mimics software. Positions of femur and tibia at 30°, 45°, and 60° of flexion were then reproduced by controlling kinematic factors. Femoral and tibial graft bending angles were measured and recorded at each position of the knee. Variations in graft bending angle in each flexion range were examined and compared between the two groups using Solidwork software.

Results: There was significant (P = 0.009) difference in variation of femoral graft bending angle between IO and retro-socket OI techniques from 0° to 90° flexion of the knee (38.83° ± 5.47° vs. 10.67° ± 7.74°, respectively). Significant (P = 0.009) difference was also noticed at 30° to 45° ROM of the knee between the two groups (6.40° ± 0.66° vs. 1.13° ± 1.26°, respectively).

Conclusions: The retro-socket OI technique resulted in less variation in femoral graft bending angle during ROM of the knee than the IO technique after PCL reconstruction.

Keywords:
Posterior cruciate ligament; Reconstruction; Femoral tunnel; Graft; Fixation
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