[Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft with moderate to long term follow-up].

OBJECTIVES

To evaluate the 4- to 10-year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction.

METHODS

From May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated, using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5 - 10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment.

RESULTS

The mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4 +/- 8.1, 94.5 +/- 9.2, and 6.9 +/- 2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P < 0.01). The average posterior displacement measured with KT2000 was (4.9 +/- 1.1) mm (90 degrees flexion) and (4.3 +/- 1.2) mm (30 degrees flexion) respectively. At the final follow-up, KT2000 examination revealed >or= 6 mm of posterior laxity in 6 patients (group A), and <or= 5 mm posterior laxity in 16 patients (group A). A statistically significant improvement was noted in comparing the mean final follow-up IKDC score, Lysholm score, and Tegner score between the group A and B (P < 0.01). The average time from injury to surgery of group A and B was (17.6 +/- 3.9) months and (2.9 +/- 2.1) months respectively, the difference was statistically significant (P < 0.01). The data was received from the Biodex dynamometer for the 22 patients who were followed up in clinic service. Patients achieved (90 +/- 22)% (60 degrees /s) and (87 +/- 19)% (120 degrees /s) recovery of the extensor peak torque respectively, for the flexor peak torque patients achieved (93 +/- 16)% (60 degrees /s) and (92 +/- 20)% (120 degrees /s) respectively, the difference between the peak torque of extensor and flexor in the same condition was statistically significant (P < 0.01). X-ray findings: 8 of the 22 patients (36.4%) were assessed as mild grade change (3 case in medial compartment isolated, 1 case in patellofemoral joint isolated, and 4 case in both compartments) and 2 patients (9.1%) as moderate grading in final follow-up radiographs (in both anterior and medial compartments), and 12 of the 22 patients (54.5%) revealed normal X-ray findings. The average time from injury to surgery of patients who revealed joint degeneration and patients who revealed normal X-ray findings was (16.6 +/- 2.7) months and (3.3 +/- 1.7) months respectively, the difference was statistically significant (P < 0.01).

CONCLUSIONS

Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft produces well results with moderate to long term follow-up. For the patients with III or IV PCL injury, PCL reconstruction should be done as soon as possible.