[Arthroscopic double-bundle posterior cruciate ligament reconstruction using quadriceps tendon-patellar bone autograft].

OBJECTIVE

To describe an alternative procedure of arthroscopic posterior cruciate ligament reconstruction using quadriceps tendon-patellar bone autograft and evaluate the early stage follow-up results.

METHODS

Twenty consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied. Quadriceps tendon with patellar bone block was used for preparation of Y-shaped autograft. Double femoral tunnels and single tibial tunnel were precisely drilled respectively at their anatomical footprint. By using this technique, the anterolateral bundle was fixed and tensioned in 90 degrees flexion, whereas the postero-medial bundle was fixed in full extension. In cases of combined injury, reconstruction or primary repair was conducted in one-stage or two-stage procedure.

RESULTS

All cases were followed up for 6 months to 12 months, averaging 7.5 months. Lysholm rating scales and IKDC evaluation were used to make clinical subjective evaluations. Anteroposterior translation was measured with KT-1000 arthrometer and stress view radiography. Final Lysholm evaluation showed 5 patients (25%) were excellent, 14 (70%) good, and 1 (5%) poor. IKDC evaluation showed that 1 patient (5%) was graded as A, 16 (80%) as B, 2 (10%) as C and 1 (5%) as D. Stress view examination and KT-1000 arthrometer measurement showed that the average posterior translation improved from 11.5 mm and 11.0 mm preoperatively to 5.2 mm and 5.5 mm postoperatively. One patient was graded as failure.

CONCLUSIONS

Arthrosopy assisted procedure of double-bundle posterior cruciate ligament reconstruction is effective and reproducible. The short follow-up clinical results are encouraging. Quadriceps tendon is an ideal autograft alternative for posterior cruciate ligament reconstruction.Combined posterior cruciate ligament injury, especially posterolateral complex insufficiency, should be early recognized and treated properly.