Arthroscopic posterior cruciate ligament reconstruction: one- vs. two-tunnel technique

As the techniques of arthroscopic surgery have evolved, so have the possibilities of reconstructing the posterior cruciate ligament (PCL). However, the indications for this procedure have been debated. We describe the results of reconstructing the PCL in 16 consecutive patients with chronic knee instability due to isolated PCL deficiency using either a patella bone-tendon-bone (pBTB) graft with proximal fixation in one femoral tunnel or double bundle hamstring grafts in two femoral tunnels. The patients were followed prospectively and had an additional evaluation after median 35 (25-51.5) months by a blinded observer. The objective stability and subjective scores increased significantly from the preoperative condition. There were no statistically significant differences in outcome between using a pBTB graft in one femoral tunnel compared with semitendinosus/gracilis grafts in two femoral tunnels. We conclude that arthroscopic reconstruction of isolated PCL ruptures improves the activity level of patients and relieves symptoms. In our study, no difference in outcome between the two techniques could be found.