To compare the results of posterior cruciate ligament reconstructions by tibial inlay and tibial tunnel techniques.

Despite of conservative treatment, all patients (31 cases) had pain and grade 2 or more posterior instability. Posterior drawer test and posterior drawer stress radiography were performed. Clinically, Lysholm knee score and Tegner activity score were evaluated.

In the tibial tunnel group, posterior drawer test demonstrated grade 1 instability in 7 cases, grade 2 in 4 cases, and grade 3 in 1 case at the last follow-up. In the tibial inlay group, there was grade 1 instability in 14 cases and grade 2 in 5 cases. On posterior drawer stress radiography, the mean side-to-side difference in measurement of the tibial tunnel group improved from 12.4 mm preoperatively to 4.0 mm at follow-up, and that of the tibial inlay group improved from 11.8 mm to 2.9 mm. Lysholm knee score and Tegner activity score improved to 86.8 points and 5.83 points, respectively, in the tibial tunnel group, and to 88.2 points and 5.84 points, in the tibial inlay group.

PCL reconstruction with the tibial inlay technique tends to maintain better posterior stability, but there is no statistically significant difference between the two techniques. Further study may be required.