This study was performed to evaluate the clinical usefulness of femoral double tunnel PCL reconstruction using the tibial inlay technique.

From January 2001 to August 2002, 21 patients underwent femoral double tunnel PCL reconstruction using the tibial inlay technique and were followed for more than 21 months. The mean age was 37 years old (range 16 to 60 years old). The clinical results were evaluated with the Lysholm score and the Tegner activity score. Radiologic analysis was performed using the posterior stress and Telos stress views.

The average preoperative Lysholm and Tegner activity scores were 46.0 and 2.3, respectively, and improved to 94.5 and 5.3, respectively, at the final follow-up. The average preoperative scores of the combined posterolateral ligament injury group was 40.6 and 1.5, which improved to 77.1 and 3.5 at the final follow-up. Preoperatively, two cases were grade II, 13 cases were grade III, 6 cases were grade IV, and posterior translation was an average of 14.6 mm. Postoperatively, 18 cases were grade I, 3 cases were grade II, and posterior translation was an average 2.9 mm. In a push view using the Telos device (15 kg) at 30° and 90° of knee flexion, there were no differences in posterior translation. Complications were limitation of flexion (3 cases), limitation of extension (1 case) and quadriceps atrophy (mean, 2.6 cm).

It is suggested that femoral double tunnel PCL reconstruction with the tibial inlay technique using anterolateral and posteromedial bundles is an effective technique for the restoration of knee function, stability, and activity. However long-term evaluation of patients and comparisons with femoral single tunnel reconstruction are required to confirm the effectiveness of this procedure.