Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons.
Arthroscopy 2009 July
PURPOSE: The purpose of this study was to evaluate the results of double-bundle posterior cruciate ligament (PCL) reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons.
METHODS: Twenty-two cases of isolated chronic PCL rupture were reconstructed arthroscopically with 8 strands of autogenous hamstring tendons in a double-bundle and 4-tunnel manner. Quadruple-stranded semitendinosus tendon graft and quadruple-stranded gracilis tendon graft were used to reconstruct the anterolateral bundle and posteromedial bundle, respectively. The grafts were fixed by use of a non-hardware suspension fixation technique.
RESULTS: Nineteen patients were followed up for a minimum of 2 years. Before surgery, 15 patients had a 2+ posterior drawer test (PDT) and 4 patients had a 3+ PDT. At a minimum of 2 years after surgery, 17 patients (89.5%) had a negative PDT, 1 patient (5.3%) had a 1+ PDT, and 1 patient (5.3%) had a 2+ PDT. The mean KT-1000 examination results (MEDmetric, San Diego, CA) changed from 9.4 +/- 1.8 mm preoperatively to 1.0 +/- 1.0 mm postoperatively (P < .001). The stress radiography results changed from 10.6 +/- 2.0 mm preoperatively to 2.0 +/- 1.2 mm postoperatively (P < .001). According to the International Knee Documentation Committee knee examination form, the results were graded as normal in 15 patients (78.9%), nearly normal in 3 patients (15.8%), and abnormal in 1 patient (5.3%). The International Knee Documentation Committee subjective results increased from 65.6 +/- 5.1 to 92.1 +/- 3.7 (P < .001), and the Lysholm score increased from 63.5 +/- 4.9 to 92.5 +/- 4.1 (P < .001). The Tegner score was 5.1 before surgery and 6.3 at the last follow-up on average.
CONCLUSIONS: The results of this study showed that arthroscopic double-bundle PCL reconstruction by use of a non-hardware suspension suture fixation technique and 8 strands of autogenous hamstring tendons can yield normal results in 78.9% of patients and nearly normal results in 15.8% at a minimum of 2 years.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
METHODS: Twenty-two cases of isolated chronic PCL rupture were reconstructed arthroscopically with 8 strands of autogenous hamstring tendons in a double-bundle and 4-tunnel manner. Quadruple-stranded semitendinosus tendon graft and quadruple-stranded gracilis tendon graft were used to reconstruct the anterolateral bundle and posteromedial bundle, respectively. The grafts were fixed by use of a non-hardware suspension fixation technique.
RESULTS: Nineteen patients were followed up for a minimum of 2 years. Before surgery, 15 patients had a 2+ posterior drawer test (PDT) and 4 patients had a 3+ PDT. At a minimum of 2 years after surgery, 17 patients (89.5%) had a negative PDT, 1 patient (5.3%) had a 1+ PDT, and 1 patient (5.3%) had a 2+ PDT. The mean KT-1000 examination results (MEDmetric, San Diego, CA) changed from 9.4 +/- 1.8 mm preoperatively to 1.0 +/- 1.0 mm postoperatively (P < .001). The stress radiography results changed from 10.6 +/- 2.0 mm preoperatively to 2.0 +/- 1.2 mm postoperatively (P < .001). According to the International Knee Documentation Committee knee examination form, the results were graded as normal in 15 patients (78.9%), nearly normal in 3 patients (15.8%), and abnormal in 1 patient (5.3%). The International Knee Documentation Committee subjective results increased from 65.6 +/- 5.1 to 92.1 +/- 3.7 (P < .001), and the Lysholm score increased from 63.5 +/- 4.9 to 92.5 +/- 4.1 (P < .001). The Tegner score was 5.1 before surgery and 6.3 at the last follow-up on average.
CONCLUSIONS: The results of this study showed that arthroscopic double-bundle PCL reconstruction by use of a non-hardware suspension suture fixation technique and 8 strands of autogenous hamstring tendons can yield normal results in 78.9% of patients and nearly normal results in 15.8% at a minimum of 2 years.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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