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PubMed2006

One-stage posterior cruciate ligament inlay reconstruction combining anterior cruciate ligament reconstruction following knee dislocation.

Knee dislocation is a rare but severe injury that involves damage to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral or medial ligamentous structures, and other soft tissues or bony structures surrounding the knee joint. No consensus exists regarding the best treatment method. This work presents a method of 1-stage ACL and PCL reconstruction in which a contralateral quadriceps tendon-bone autograft with tibial inlay technique is used for the PCL and contralateral hamstring tendon autograft with suspension fixation is used for the ACL. After harvesting grafts, the patient is put in the lateral decubitus position. Under arthroscopy, the femoral tunnel for the anterolateral bundle of the PCL is created using an 8-mm reamer via a prepositioned guide pin. Next, the tibial tunnel of the ACL is created with an appropriate diameter cannulated reamer. Directed by the femoral guide instrument with a 7-mm offset, a guide pin is positioned retrograde through the tibial tunnel. A reamer is then used to create a 35-mm long closed-ended femoral tunnel for the ACL. A posterior arthrotomy for the PCL inlay technique is performed. After capsulotomy, a unicortical window is created at the footprint of the PCL and the inlay graft is fixed using a 3.5mm-cancellous screw and washer. The PCL graft is then passed into the femoral tunnel. The ACL graft is passed in a retrograde fashion using the Beath pin. The ACL graft is fixed by tying with a washer on the femoral side and by tying with a screw on the tibial side. The PCL graft is then fixed on the femoral side.

Anterior Cruciate Ligament↗

PubMed1997

Inlay-onlay flap urethroplasty for hypospadias and urethral stricture repair.

PURPOSE: The absence of a segment of the urethral plate renders the onlay urethroplasty procedure impossible. The plate may be too short (in hypospadias), or scarred after previous repair or due to a dense urethral stricture. A modified approach with restoration of urethral plate continuity is proposed instead of the tubularized island flap associated with higher complication rates. MATERIAL AND METHODS: In 12 of 20 patients with a partially deficient urethral plate the inlay-onlay preputial island flap was used. The wider part of the flap is inlaid in place of the missing plate and anastomosed to the residual plate. Formation of the urethra is then completed with standard onlay overlapping of the flap. In another 8 patients the combined (partially tubularized in advance) tube-onlay flap was used. RESULTS: The inlay-onlay flap technique was used in 3 new hypospadias patients, in 4 with a scarred, hair-bearing plate after previous operations and in 5 with virtually no urethral plate because of a dense urethral stricture. No urethral complications were encountered. Of the 8 patients undergoing the combined tube-onlay repair 3 had complications, including meatal stenosis (2) and partial dehiscence (1). CONCLUSIONS: Inlay-onlay flap urethroplasty allows correction of complex cases of hypospadias or urethral stricture with a partially deficient urethral plate in 1 stage with a low complication rate.

Adolescent↗

PubMedDate not supplied

Polymerization contraction stress in dual-cure cements and its effect on interfacial integrity of bonded inlays.

OBJECTIVES: To compare the polymerization contraction stress of resin cements in dual-cure and self-cure modes, and verify its effect on microleakage and gap formation in class I cavities restored with porcelain inlays. METHODS: Dual-cure cements (Calibra, Choice and RelyX ARC) were monitored for contraction stress during 30 min in the tensilometer, in the presence or absence of photo-activation. Microleakage was evaluated in porcelain inlays bonded to cavities prepared in bovine incisors, combining the same adhesive (One-Step) with each of the cements in both activation modes. Epoxy replicas of the sectioned specimens were analyzed in the SEM to determine the percentage of discontinuous margins. RESULTS: The stress developed in dual-cure mode was higher than in self-cure mode for all cements. In self-cure mode, no significant difference in stress was found among materials. Choice and RelyX ARC showed higher microleakage in dual-cure mode than in self-cure mode. Calibra did not show a significant difference in microleakage between activation modes. Contraction gap results showed wide variations, and no significant differences were detected among the groups. Gaps occurred more often in dentin, with an overall average of 22 +/- 17.5%. CONCLUSIONS: The higher stress generated in dual-cure cements subjected to photo-activation may lead to higher marginal leakage. In the confinement condition represented by the class I inlay, even the lower contraction stress of the cements in self-cure mode had enough magnitude to disrupt the bonding to dentin.

Animals↗

PubMed1995

Small-diameter corneal inlay in presbyopic or pseudophakic patients.

We report the results of using the small-diameter corneal inlay to create a bifocal cornea. The inlay was implanted in five eyes in January 1993. At 12 months postoperatively, uncorrected near vision had improved from J4 to better than J2 in four of the five. The results indicate that the corneal inlay improves near vision and is compatible within the cornea.

Adult↗

PubMed2002

PTFE-fascia patch inlay method for the anterior approach for cervical intradural spinal lesion.

STUDY DESIGN: A new method for prevention of cerebrospinal fluid leakage was studied. OBJECTIVE: To prevent cerebrospinal fluid leakage, we developed a polytetrafluoroethylene fascia patch inlay method. BACKGROUND: One of the major risks of the anterior approach for intra-dural spinal cord lesions is the cerebrospinal fluid leakage. METHODS: A small hemangioblastoma located on the ventral side of the cervical cord was resected with an anterior approach. The dural closure was performed using this polytetrafluoroethylene fascia patch inlay method. RESULTS: The patient had a satisfactory clinical course with no cerebrospinal fluid leakage. CONCLUSION: This polytetrafluoroethylene fascia patch inlay method is very effective. This method may provide both prevention of CSF leakage and future spinal cord adhesion to the dura.

Cervical Vertebrae↗

PubMedDate not supplied

[Prospective randomized comparative study of early functional outcome of 2 knee joint endoprosthesis systems--rotation plateau versus fixed polyethylene inlay].

AIM: Different systems are used for total knee arthroplasty (TKA). Compared were a press-fit femur condyle replacement system with fixed tibial PE-inlay versus a rotating tibia component system with an emphasis on the early functional results. METHOD: Patient selection and the use of the Knee Society Score for this randomized and prospective study were based on the directives for TKA of the german Society for Orthopaedic and Trauma Surgery (DGOT). We examined the patients post-operatively after 1 week, 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. RESULTS: After 6 weeks an increase of the total knee score could be seen in both groups. The total knee score of the rotating tibia component increased from 93.96 pre-operatively to 113.57 after 6 weeks, to 139.82 after 3 months, to 154.32 after 6 months, and to 159.65 after one year. The total score with the fixed PE-inlay increased from 79.75 to 111.5 after 6 weeks, to 128.25 after 3 months, to 134.08 after 6 months, and to 130.08 after one year. CONCLUSION: After 6 weeks the implant with the rotating tibia component showed a lasting higher score as compared to the implant with a fixed PE-inlay component using the same early rehabilitation and mobilization techniques.

Aged↗

PubMed2002

Early revascularization of membranous inlay bone graft in canine mandible model.

The early revascularization of a membranous inlay bone graft in a canine mandible was investigated using bone scans and histological examinations. Eight 5-month-old mongrel dogs were used as the subjects. The inlay bone graft, a 1- x 2-cm critically sized bone, was completely separated from the lower border of the canine mandible and then refixed to the original site. Bone scans and histological examinations were performed in the first, second, third, and fourth postoperative weeks. The bone scan in the first postoperative week revealed radioisotope uptake on the margin of the grafted bone with an isotope count that was 21% of the normal bone uptake. In the second postoperative week, the radioisotope uptake in the grafted bone increased to 52% of the normal bone uptake. In the third and fourth postoperative weeks, the isotope uptakes were 111% and 124%, respectively. The histological findings in the first postoperative week showed an absence of osteoblastic activity and 6 viable blood vessels in a field magnified x 200, which was the equivalent of 25% of the vessels of the normal bone. In the second postoperative week, osteoblastic activity was noted, and the number of viable blood vessels increased to 15, that is, 63% of the vessels of the normal bone. In the third postoperative week, there was an increase in osteoblastic activity, and the number of viable blood vessels was 21, that is, 88% of the vessels of the normal bone. In the fourth postoperative week, there was a marked increase in osteoblastic activity with the number of vessels reaching 23, that is, 96% of the normal bone. In summary, revascularization of the membranous inlay bone graft began within the first week after the bone graft and thereafter gradually increased. In the third postoperative week, revascularization returned to a near-normal value compared with the value of the adjacent normal mandibular bone.

Animals↗

PubMed2001

Effect of isolation of periosteum and dura on the healing of rabbit calvarial inlay bone grafts.

Little is understood about the role of the recipient site in the revascularization and incorporation of autogenous inlay bone grafts in the craniofacial skeleton. Clinical experience demonstrates that secondary complex cranial vault reconstruction performed with scarred avascular dura or poor soft-tissue coverage may undergo significant resorption, thus compromising the aesthetic outcome. This study was designed to determine the effect of isolating autogenous orthotopic inlay calvarial bone grafts from the surrounding dura and/or periosteum on graft revascularization, healing, and volume maintenance in the adult rabbit. Adult rabbits were randomized into four groups (n = 10 per group); in each rabbit, the authors created a circular, 15-mm in diameter, full-thickness cranial defect followed by reconstruction with an autogenous calvarial bone graft, which was replaced orthotopically and held with microplate fixation. Silicone sheeting (0.5 mm thickness) was used to isolate the dura (group II), the periosteum (group II), or both dura and periosteum (group IV) from the graft interface. No silicone was placed in group I. Animals were killed 10 weeks postoperatively, and calvaria were harvested to assess graft surface area, morphology, quantitative histology, fluorochrome staining, and revascularization. Grafts isolated from both the dura and periosteum exhibited significant decreases in total bone (cortical and trabecular) surface area, blood vessel count, and interface healing compared with nonisolated control grafts. Isolation of either the dura or periosteum significantly (p < 0.05) decreased blood vessel count but had no significant effect on interface healing. Isolation of the dura alone was associated with a significant (p < 0.05) decrease in graft cross-sectional surface area and dural cortical thickness compared with nonisolated control grafts, but this effect was not observed when the periosteum alone was isolated. Quantitative histology performed 10 weeks after surgery indicated that graft isolation was associated with increased marrow fibrosis and necrosis compared with nonisolated controls; it also demonstrated evidence of increased activity in bone remodeling (osteoblast and osteocyte count, new trabecular bone, and surface resorption). Triple fluorochrome staining suggested increased bone turnover in the nonisolated grafts compared with isolated grafts at 1 and 5 weeks postoperatively. This study demonstrates that isolating a rabbit calvarial inlay autogenous bone graft from the dura and/or periosteum results in significantly (p < 0.05) decreased revascularization, interface healing, and cross-sectional areas of amount of mature bone compared with nonisolated control grafts 10 weeks after surgery. At this time point, histologic examination demonstrates a paradoxical increase in bone remodeling in isolated bone grafts compared with controls. It is possible that the inhibition of revascularization results in a delayed onset of the remodeling phase of graft incorporation. However, in the model studied, it is not known whether the quantitative histologic and morphometric parameters measured in these isolated grafts exhibit a "catch-up" phenomenon at time points beyond 10 weeks after surgery. The results of this study emphasize the importance of a healthy recipient site in the healing and incorporation of calvarial bone grafts but stress the need for further investigation at later time points.

Animals↗

PubMed2006

Butterfly cartilage graft inlay tympanoplasty for large perforations.

OBJECTIVE: Butterfly graft inlay tympanoplasty is a well-established technique for the repair of small perforations. However, the efficacy of the technique for medium and large tympanic membrane perforations remains unknown. STUDY DESIGN: Retrospective case series. METHODS: Postauricular tympanoplasty and tympanomastoidectomy using a large butterfly cartilage inlay graft (>4 mm diameter to total drum replacement) were analyzed in 90 pediatric patients (99 ears). RESULTS: Patient ages ranged from 2 to 20 years; mean follow-up duration was 27.6 months. Successful closure occurred in 92% of the ears. No graft lateralized nor displaced into the middle ear. No retraction pocket occurred during the follow-up period. In 62 cases, intact canal wall or canal wall window tympanomastoidectomy was performed; Fifty-one (82.2%) of the patients having mastoidectomy procedures had chronic otitis media with cholesteatoma. The mean preoperative to postoperative four-tone air-bone gap improved from 23 to 21 dB; the number of patients with 0 to 10 dB hearing results increased from 16 ears preoperatively to 32 ears postoperatively. Postoperative suboptimal results included eight patients with postoperative perforations in the residual tympanic membrane adjacent to an intact cartilage graft; two of these patients were the only individuals who exhibited otorrhea. CONCLUSIONS: Cartilage butterfly graft inlay tympanoplasty is effective in the vast majority of patients with moderate to large perforations. The closure rate exceeded 90% with no graft displacement, postoperative adverse events were respectably low, and hearing results improved or remained stable despite the need for concurrent mastoidectomy in the majority of patients.

Adolescent↗

PubMedDate not supplied

A biomechanical comparison of tibial inlay and tibial tunnel posterior cruciate ligament reconstruction techniques: graft pretension and knee laxity.

BACKGROUND: Most posterior cruciate ligament reconstruction techniques use a tibial bone tunnel, which results in an acute bend in the graft as it passes over the posterior portion of the tibial plateau. HYPOTHESIS: The tibial inlay technique will result in lower graft pretensions, less laxity, and less stretch-out after cyclic loading. STUDY DESIGN: Controlled laboratory study. METHODS: Graft pretensions necessary to restore normal laxity at 90 degrees of knee flexion (laxity match pretension) and anteroposterior laxities at five knee flexion angles were recorded in 12 fresh-frozen knee specimens with bone-patellar tendon-bone posterior cruciate ligament graft reconstructions using both techniques and two femoral tunnel positions. RESULTS: When the graft was placed in a central femoral tunnel, the tibial tunnel reconstruction required an average 15.6 N greater laxity match pretension than the tibial inlay reconstruction. There were no significant differences in mean knee laxities between the tibial tunnel and tibial inlay techniques at any knee flexion angle; both reconstruction techniques restored mean knee laxity to within 1.6 mm of intact knee values over the entire flexion range. CONCLUSIONS: There was no important advantage of one technique over the other with respect to the biomechanical parameters measured.

Adult↗

PubMedDate not supplied

Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: analysis of knee kinematics and graft in situ forces.

BACKGROUND: 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. HYPOTHESIS: 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. METHODS: 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. RESULTS: 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. CLINICAL RELEVANCE: The study suggests that either technique may be performed with similar biomechanical results at initial fixation under these loading conditions.

Adult↗

PubMed2004

The effect of posterior knee capsulotomy on posterior tibial translation during posterior cruciate ligament tibial inlay reconstruction.

PURPOSE: To measure the biomechanical effect of the surgical capsulotomy made during a posterior cruciate ligament reconstruction using the tibial inlay technique. HYPOTHESIS: The posterior capsule contributes to posterior tibial stability. STUDY DESIGN: Controlled laboratory experiment. METHODS: Six knee specimens were tested on a robotic testing system from 0 degrees to 120 degrees of flexion with the posterior cruciate ligament intact and resected and with a posterior capsulotomy identical to that performed during tibial inlay reconstruction (sham surgery). A longitudinal incision with medial and lateral soft tissue stripping sufficient to mount an inlay bone block and pass an Achilles tendon graft into the knee was made in the oblique popliteal ligament, muscle belly of the popliteus, and posterior capsule. The posterior tibial translation was measured under a posterior tibial load of 130 N at multiple flexion angles. RESULTS: Capsulotomy increased the posterior laxity compared with the posterior cruciate ligament-resected knee at every flexion angle. An additional 0.97 +/- 0.48 mm, 0.65 +/- 0.47 mm, 0.56 +/- 0.33 mm, 0.48 +/- 0.38 mm, and 0.94 +/- 0.60 mm of posterior laxity was recorded at 0 degrees, 30 degrees, 60 degrees, 90 degrees, and 120 degrees of flexion, respectively. These values were all statistically significant (P < .001). CONCLUSIONS: A posterior capsulotomy alone, without associated posteromedial or posterolateral disruption, produces additional posterior tibial translation in vitro compared with posterior cruciate ligament-deficient knee with intact capsule. CLINICAL RELEVANCE: Damage to the posterior capsule may contribute to the residual posterior laxity noted clinically after posterior cruciate ligament reconstruction.

Achilles Tendon↗

PubMed2005

Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane perforations.

There is a current effort to perform myringoplasty for tympanic membrane perforations as a day-stay procedure. In 1998, an inlay myringoplasty using tragal cartilage/perichondrium was described. A retrospective study was performed by the author to analyse the results of inlay cartilage myringoplasty, in terms of closure of simple perforations of the tympanic membrane. The results of a control group of previous cases of underlay temporalis fascia myringoplasty were retrieved from the hospital records. All the operations in both groups were performed by the same author at the same institution. The operation of inlay cartilage butterfly myringoplasty has been performed in 28 ears with simple central tympanic membrane perforations. Inconsistent results have been obtained, in that only 43 per cent showed closure of the perforation at the most recent follow-up. A control group of standard underlay temporalis fascia myringoplasty has been performed by the same author in 23 ears. Eighty-three per cent of the perforations were closed at the last follow-up. The difference is statistically highly significant (p < 0.01).

Adolescent↗

PubMed2002

Biomechanical comparison of tibial inlay and tibial tunnel techniques for reconstruction of the posterior cruciate ligament. Analysis of graft forces.

BACKGROUND: The tibial inlay technique of reconstruction of the posterior cruciate ligament offers potential advantages over the conventional transtibial tunnel technique, particularly with regard to the graft force levels that develop over a functional range of knee flexion. Abnormally high graft forces generated during rehabilitation activities could lead to stretch-out of the graft during the critical early healing period. The purpose of this study was to compare graft forces between these two techniques and with forces in the native posterior cruciate ligament. METHODS: A load cell was installed at the femoral origin of the posterior cruciate ligament in twelve fresh-frozen cadaveric knees to measure resultant forces in the ligament during a series of knee loading tests. The posterior cruciate ligament was then excised, and the femoral ends of 10-mm-wide bone-patellar tendon-bone grafts were attached to the load cell to measure resultant forces in the grafts. For the tunnel reconstruction, the distal bone block of the graft was placed into a tibial tunnel and thin stainless-steel cables interwoven into the bone block were gripped in a split clamp attached to the anterior tibial cortex. With the inlay technique, the distal bone block was fixed in a tibial trough with use of a cortical bone screw with a washer and nut. The proximal ends of all grafts were pretensioned to a level of force that restored intact knee laxity at 90 degrees of flexion, and loading tests were repeated. RESULTS: There were no significant differences in mean graft forces between the two techniques under tibial loads consisting of 100 N of posterior tibial force, 5 N-m of varus and valgus moment, and 5 N-m of internal and external tibial torque. Mean graft forces with the tibial tunnel technique were approximately 10 to 20 N higher than those with the inlay technique with passive knee flexion beyond 95 degrees. Mean graft forces with both reconstruction techniques were significantly higher than forces in the native posterior cruciate ligament with the knee flexed beyond approximately 90 degrees for all but one mode of loading. CONCLUSIONS: In this cadaveric testing model, neither technique for reconstruction of the posterior cruciate ligament had a substantial advantage over the other with respect to generation of graft forces.

Aged↗

PubMed2004

Replacement of the torn posterior cruciate ligament with a mid-third patellar tendon graft with use of a modified tibial inlay method.

BACKGROUND: The tibial inlay method for reconstruction of the posterior cruciate ligament has been performed with the patient in the prone or lateral decubitus position. The purpose of this report is to present a modification of this method wherein the patient is positioned supine throughout the procedure. METHODS: Between May 1995 and September 1998, twelve patients who had an isolated tear of the posterior cruciate ligament underwent reconstruction with use of the modified tibial inlay technique. Eleven patients were evaluated after a minimum duration of follow-up of two years. Stability was measured on posterior stress radiographs and with a maximum manual displacement test performed with a KT-1000 arthrometer. Clinical evaluation was carried out with use of the scoring systems of the Orthopädische Arbeitsgruppe Knie and the International Knee Documentation Committee. Second-look arthroscopy was performed in five patients at the time of follow-up. RESULTS: The mean side-to-side difference in displacement (and standard deviation) was reduced from 10.8 +/- 1.9 mm preoperatively to 3.4 +/- 2.4 mm at the time of follow-up as measured on the stress radiographs, and it was reduced from 9.0 +/- 2.1 mm preoperatively to 1.8 +/- 1.2 mm at the time of follow-up as measured with the KT-1000 arthrometer. The average Orthopädische Arbeitsgruppe Knie score was improved from 71.6 +/- 6.8 to 92.5 +/- 4.8 points. All eleven patients had a satisfactory clinical outcome at the time of the final clinical evaluation. The second-look arthroscopic examination in the five patients showed no evidence of partial tearing or abrasion of the graft. CONCLUSIONS: Use of our modified tibial inlay technique for reconstruction of the posterior cruciate ligament achieved a good clinical result in eleven of twelve patients. The advantages of the technique are (1) minimal tendon abrasion at the posterior opening of the tibial tunnel, and (2) elimination of the need to change the patient's position during surgery.

Adolescent↗

PubMed2005

Reconstruction of the posterior cruciate ligament with a mid-third patellar tendon graft with use of a modified tibial inlay method.

Arthroscopy↗

PubMed2000

The dorsal inlay graft for hypospadias repair.

PURPOSE: Hypospadias is a common genitourinary anomaly affecting every 1/300 male newborns. The goals of hypospadiac surgery include a straight penis with a urethral meatus at the tip of the glans, a well vascularized neourethra of adequate caliber with a solid, straight urinary stream and achievement of sexual function when mature. Current theory advocates preservation of the urethral plate with chordee correction. Hypospadias repair without an adequate urethral plate to roll into a tube requires longitudinal incision of the plate or a transverse preputial island flap. We describe a technique of 1-stage urethroplasty using an inner preputial based dorsal inlay graft. MATERIALS AND METHODS: After the penis is degloved and chordee corrected incisions are made bilaterally along the urethral plate from the native urethral meatus to the glans tip. The urethral plate is incised longitudinally. A graft harvested from the inner prepuce is defatted and sutured onto the incised urethral plate. The neourethra is rolled into a tube in Thiersch-Duplay fashion. RESULTS: This technique was used in 32 patients. The original urethral meatus was coronal to penoscrotal and chordee release was performed concomitantly. At 21 months of followup no patient had a stricture, fistula or diverticulum at the inlay graft site. CONCLUSIONS: This technique successfully fulfills all traditional hypospadias repair criteria. We believe that the dorsal inlay graft after incision of the urethral plate is a rapid, easy and successful addition to the armamentarium of the "hypospadiologist."

Child↗

PubMed2002

Vascular risk associated with a posterior approach for posterior cruciate ligament reconstruction using the tibial inlay technique.

This study evaluated the risk to the popliteal artery associated with the tibial inlay technique in posterior cruciate ligament (PCL) reconstruction. Barium was injected into the femoral arteries of eight fresh-frozen cadaveric knees and anteroposterior (AP) radiographs were obtained. Dissection of the fascia overlying the gastrocnemius muscle, identification of the interval between the medial head of the gastrocnemius and the semimembranosus, and lateral retraction of the medial head of the gastrocnemius (the Burks and Schaffer approach) was performed. Subsequently, a bicortical screw was placed from posterior to anterior through the tibia as is performed in the tibial inlay technique. A second AP radiograph was obtained. The distance from the center of the screw to the edge of the popliteal artery was measured using digital calipers. The closest any screw came to the popliteal artery was 18.1 mm, and the average distance was 21.1 mm (21.1 +/- 4.6 mm, range: 18.1-31.7 mm). When this distance was calculated as a percentage of the tibial plateau width, the smallest value was 19.2% (24% +/- 4.9%, range: 19.2%-35.1%). A posterior approach for a tibial inlay PCL reconstruction procedure appears safe with respect to the popliteal artery.

Aged↗