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Published on: April 30, 2014
Simultaneous arthroscopic reconstruction of the anterior and posterior cruciate ligaments with autogenous hamstring
Jinzhong Zhao1, Yaohua He, Jianhua Wang
1Department of Arthroscopic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China. zhaojinzhong@vip.163.com
Purpose:
The purpose of this study was to evaluate the clinical results of simultaneous arthroscopic reconstruction of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with hamstring tendons.
Type Of Study:
Retrospective case series.
Methods:
Twelve cases of combined ACL/PCL ruptures were reconstructed arthroscopically with hamstring tendons in 1 stage. The semitendinosus tendon of the injured leg was used for 4-stranded ACL reconstruction, and the semitendinosus tendon and gracilis tendon of the uninjured leg were used for 6- to 8-stranded PCL reconstruction. The patients were followed-up for 32 months on average. Function was evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm scales. Anterior and posterior knee laxity were examined using the KT-1000 arthrometer.
Results:
No patients showed knee extension limitation. Knee flexion was 143 degrees +/- 3.7 degrees on average (range, 130 degrees to 150 degrees ). KT-1000 examination showed that the side-to-side difference of overall anterior-posterior laxity at 70 degrees of flexion was 0 to 2 mm in 7 patients, 3 to 5 mm in 4 patients, and 7 mm in 1 patient; the side-to-side difference of posterior sag at 70 degrees of flexion was 0 to 2 mm in 9 patients and 3 to 4 mm in 3 patients; the side-to-side difference of anterior laxity at 25 degrees of flexion was 0 to 2 mm in 8 patients, 3 to 5 mm in 3 patients, and 7 mm in 1 patient. The Lysholm score of the 9 chronic cases was 66.5 +/- 8.1 before surgery and 91.8 +/- 4.6 at the last follow-up (P < .01). According to the last IKDC evaluation, 7 patients (58.33%) were graded A, 4 patients (33.3%) B, and 1 patient (8.33%) C. Except for 1 patient who complained of mild pain at the donor site of the contralateral healthy knee, no patients complained of donor-site morbidity or dysfunction of the healthy leg.
Conclusions:
Simultaneous arthroscopic reconstruction of the ACL and PCL with autogenous hamstring tendons is reliable for the restoration of knee stability.
Level Of Evidence:
Level IV.