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Related Experiment Video

Updated: Feb 8, 2026

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Posterior laxity increases over time after PCL reconstruction.

Clemens Gwinner1, Tobias M Jung2, Imke Schatka3

  • 1Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. clemens.gwinner@charite.de.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|July 4, 2018
PubMed
Summary

Posterior tibial translation (PTT) improves after posterior cruciate ligament (PCL) reconstruction but increases over time. Surgeons must note that early stability does not predict long-term outcomes, especially with a flattened tibial slope.

Keywords:
Ligament reconstructionPosterior cruciate ligamentPosterior tibial translationTibial slopeTimely increment

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Knee kinematics

Background:

  • Restoring posterior tibial translation (PTT) is crucial for knee function after posterior cruciate ligament (PCL) reconstruction.
  • Current surgical methods often fail to fully resolve posterior laxity.

Purpose of the Study:

  • To investigate the hypothesis that PTT increases over time following PCL reconstruction.
  • To evaluate the long-term changes in PTT and their correlation with factors like tibial slope.

Main Methods:

  • A prospective study of 46 patients undergoing PCL reconstruction.
  • Bilateral stress radiographs were taken preoperatively and at multiple time points up to a minimum 5-year final follow-up.
  • Radiographs assessed tibial slope (TS) and PTT; patient demographics and surgical details were recorded.

Main Results:

  • PTT significantly improved from preoperative to 3 months post-surgery (10.9mm to 3.6mm).
  • However, PTT significantly increased from 3 months to final follow-up (3.6mm to 5.4mm), particularly in patients with a flattened TS.
  • Age, gender, BMI, and number of operated ligaments did not significantly influence PTT outcomes.

Conclusions:

  • While PCL reconstruction initially improves PTT, a significant increase in laxity occurs by the final follow-up.
  • Flattening of the tibial slope is associated with higher PTT at long-term follow-up.
  • Initial postoperative stability should not be considered indicative of the final functional outcome.