Purpose: The purpose of this study was to compare clinical results of arthroscopic posterior
cruciate ligament (PCL) reconstructions using double-loop hamstring tendon autograft
and Achilles tendon allograft while preserving the original PCL remnant. Type of Study: Case-control study of results of treatment. Methods: From September 1997 to December 2000, 36 patients who received only PCL reconstruction
were reviewed retrospectively. Of these, 18 patients received autogenous double-loop
hamstring tendon reconstruction (group I) and 18 received Achilles tendon allograft
reconstruction (group II). The same PCL reconstruction procedure was performed in
both groups. At final follow-up at a minimum of 2 years, patients were evaluated by
4 measures: the International Knee Documentation Committee (IKDC) evaluation, Lysholm
knee scores, the posterior draw test, and Telos stress radiography. Results: Between the 2 groups, preoperative demographic factors (age, gender, activity level,
and mean duration to surgery) showed no statistically significant difference (P > .05). According to IKDC evaluation of group I, 16 of the 18 knees rated normal
or nearly normal, whereas 2 fell into the abnormal category. By the same criteria,
14 of the 18 knees in group II were normal to nearly normal, 3 were abnormal, and
1 was severely abnormal. IKDC scores showed no statistical difference between the
2 groups (P = .98). Postoperative mean Lysholm knee scores were 90 points (range, 78–100) for
group I and 85 (range, 70–95) for group II; improvements of 22 and 17 points, respectively.
According to the Lysholm knee scores, group I showed slightly better results than
did group II, with a statistical significance of P < .01. Telos stress radiography showed the mean difference in posterior translation
between the injured and uninjured knees to be 2.2 mm (range, 0 to 7.0 mm) for group
I and 2.9 mm (range, 1.0 to 7.0 mm) for group II. The Telos stress test showed no
statistical difference between the 2 groups (P = .14). Conclusions: The clinical outcome was the same for both groups. Despite its comparatively short
length and small diameter, the double-loop hamstring tendon autograft was as good
as Achilles tendon allograft in PCL reconstruction. Level of Evidence: Level III, case-control study.
Key Words
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References
- Fiber orientation of posterior cruciate ligament: An experimental morphological and functional study. Part 2.Clin Anat. 1995; 8: 315-322
- The anatomic origin of the posterior cruciate ligament: Where is it? Reference landmarks for PCL reconstruction.Arthroscopy. 1997; 13: 325-331
- Biomechanical comparison of tibial inlay and tibial tunnel techniques for reconstruction of the posterior cruciate ligament. Analysis of graft forces.J Bone Joint Surg Am. 2002; 84: 938-944
- Effects of knee position, graft tension, and mode of fixation in posterior cruciate ligament reconstruction.Arthroscopy. 2002; 18: 496-501
- Arthroscopic posterior cruciate ligament reconstruction using the posterior trans-septal portal.Arthroscopy. 2003; 19: 101-107
- Graft choice and graft fixation in PCL reconstruction.Knee Surg Sports Traumatol Arthrosc. 2003; 11: 297-306
- Arthroscopically assisted combined posterior cruciate ligament/posterior lateral complex reconstruction.Arthroscopy. 1996; 12: 521-530
- Reconstruction of the posterior cruciate ligament with allograft.Clin Sports Med. 1994; 13: 581-597
- Clinical comparison of freeze-dried and fresh frozen patellar tendon allografts for anterior cruciate ligament reconstruction of the knee.Am J Sports Med. 1990; 18: 335-342
- Retroviral transmission in bone allotransplantation. The effects of tissue processing.Clin Orthop. 1996; 324: 275-282
- Freeze dried anterior cruciate ligament allografts. Preliminary studies in a goat model.Am J Sports Med. 1987; 15: 295-303
- Freeze-dried fascia lata allografts in the reconstruction of anterior cruciate ligament defects. A two- to seven-year follow-up study.Clin Orthop. 1994; 303: 56-66
- Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendons.Am J Sports Med. 1991; 19: 478-484
- Tensile strength of the human posterior cruciate ligament (PCL).Trans Orthop Res Soc. 1988; 13: 195
- Arthroscopic posterior cruciate ligament reconstruction using four-strand hamstring tendon graft and interference screws.Arthroscopy. 1997; 13: 661-665
- Arthroscopic posterior cruciate ligament reconstruction using hamstring tendons.Arthroscopy. 1996; 12: 638-642
- Arthroscopic reconstruction of the posterior cruciate ligament with quadruple hamstring tendon graft.J Trauma. 2002; 52: 938-945
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© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
