Arthroscopic single-bundle reconstruction of posterior cruciate ligament with quadrupled hamstring tendon

To evaluate the technique and outcome of arthroscopic single-bundle reconstruction of posterior cruciate ligament (PCL) with quadrupled hamstring tendon.

From April 2001 to October 2004, 49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears, 14 with disruptions of the posterolateral corner, 6 with ruptures of the posteromedial corner and medial collateral ligament, 9 with lateral meniscus tears, 5 with medial meniscus tears and 2 with popliteal vascular tears. All the damaged PCLs were reconstructed with single-bundle of autogenous quadrupled hamstring tendons under arthroscope. Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament.

After operation, no severe complications occurred at early stage in the 49 patients. All of them were followed up for 10-52 months with an average of 22.0 months+/-10.7 months. Lysholm score was remarkably improved from 30-60 (mean: 47.96+/-8.16) preoperatively to 70-95 (mean: 89.08+/-6.10) at the last postoperative follow-up (P less than 0.01). Furthermore, there was a significant improvement in International Knee Documentation Committee (IKDC) score from abnormal (Grade C) in 10 knees and severely abnormal (Grade D) in 39 preoperatively to normal (Grade A) in 20, nearly normal (Grade B) in 24 and abnormal in 5 at the last follow-up. Of the 49 patients, 40 returned to the same activity level as before and 9 were under the level.

Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.