Dynamic double tendon replacement of the posterior cruciate ligament

Reconstruction of the posterior cruciate ligament combined with medial capsular repair was performed in eight men and four women whose average age was 29 years. In an effort to simulate the tensile behavior of the two major divisions of the posterior cruciate ligament, i.e., the anterolateral and posteromedial portions, we used the gracilis and semitendinosus tendons as substitutes. Since we consider this a dynamic operation, we feel its full benefits are measured better by functional parameters than by purely objective parameters. Accordingly, followup between 1 and 4 years (averaging 32 months) revealed all patients were subjectively pleased with their operative results. Postoperative objective evaluation still demonstrated a positive posterior drawer sign (although decreased) in all cases and a diminished medial joint space opening in most cases. Thigh girth differences were found at followup in most cases, probably as a result of disproportionate activity of the contralateral extremity. We feel that our dynamic reconstruction is an excellent alternative when one is considering surgery for a torn posterior cruciate ligament.