Double-Bundle Posterior Cruciate Ligament Reconstruction Using a Non-Hardware Suspension Fixation Technique and 8 Strands of Autogenous Hamstring Tendons
Received 21 June 2008; accepted 19 January 2009.
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.
Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China
Address correspondence and reprint requests to Baicheng Chen, M.D., Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Zhiqiang Road, Shijiazhuang, Hebei Province 050051, China
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