Margheritini Fabrizio, Mauro Craig S, Rihn Jeffrey A, Stabile Kathryne J, Woo Savio L-Y, Harner Christopher D
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Sports Med. 2004 Apr-May;32(3):587-93. doi: 10.1177/0363546503261717.
The tibial inlay technique for posterior cruciate ligament reconstruction has been proposed to provide a more anatomic reconstruction because it eliminates the sharp turn in the graft as it exits the proximal margin of the tibial tunnel in the transtibial technique.
Reconstruction of the posterior cruciate ligament using the tibial inlay technique would more closely restore intact knee kinematics and in situ forces in the posterior cruciate ligament than would reconstruction using the transtibial technique.
Ten human cadaveric knees were tested in a controlled laboratory study. A robotic/universal force-moment sensor testing system was used to apply a 134-N posterior tibial load at 5 knee flexion angles: 0 masculine, 30 masculine, 60 masculine, 90 masculine, and 120 masculine. Four knee conditions were tested: intact, posterior cruciate ligament-deficient, and the single-bundle tibial inlay reconstruction and transtibial posterior cruciate ligament reconstruction.
Both reconstruction techniques restored posterior tibial translations to 1.7 to 2.1 mm of the intact knee, with no statistical differences between the techniques. In response to the posterior tibial load, in situ forces in both grafts were between 7 and 39 N less than those in the intact posterior cruciate ligament, with no significant differences between the grafts.
The study suggests that either technique may be performed with similar biomechanical results at initial fixation under these loading conditions.
后交叉韧带重建的胫骨嵌体技术被认为能提供更符合解剖结构的重建，因为它消除了经胫骨技术中移植物穿出胫骨隧道近端边缘时的急转弯。
与经胫骨技术重建相比，使用胫骨嵌体技术重建后交叉韧带能更接近地恢复完整膝关节的运动学和后交叉韧带的原位力。
在一项对照实验室研究中对10个新鲜人尸体膝关节进行测试。使用机器人/通用力-力矩传感器测试系统在5个膝关节屈曲角度（0°、30°、60°、90°和120°）施加134 N的胫骨后向负荷。测试了四种膝关节状态：完整、后交叉韧带缺失、单束胫骨嵌体重建和经胫骨后交叉韧带重建。
两种重建技术均将胫骨后向平移恢复至完整膝关节的1.7至2.1 mm，两种技术之间无统计学差异。响应胫骨后向负荷时，两种移植物的原位力均比完整后交叉韧带的原位力小7至39 N，移植物之间无显著差异。
该研究表明，在这些负荷条件下，初始固定时两种技术均可获得相似的生物力学结果。
