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Comparison of the Clinical Results of Three Posterior Cruciate Ligament Reconstruction Techniques

¹ Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University Health System, College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-P. Kung: ypkung{at}gmail.com

Investigation performed at the Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University Health System, College of Medicine, Seoul, South Korea

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: We evaluated twenty-nine patients treated with primary posterior cruciate ligament reconstruction and followed for longer than two years. Eight patients were treated with a transtibial single-bundle procedure; eleven, with an arthroscopic inlay single-bundle procedure; and ten, with an arthroscopic inlay double-bundle procedure. An Achilles tendon allograft was used in all cases. Each patient was evaluated on the basis of the Lysholm knee score, the mean side-to-side difference in tibial translation as measured on Telos stress radiographs, and the side-to-side difference in the range of motion of the knee.

Results: The mean side-to-side difference (and standard deviation) in posterior tibial translation differed significantly between the arthroscopic tibial inlay double-bundle group (3.6 ± 1.43 mm) and the transtibial single-bundle group (5.6 ± 2.00 mm) (p = 0.023), although there was no significant difference between the arthroscopic inlay single-bundle group (4.7 ± 1.62 mm) and the transtibial group (p = 0.374). The mean range of motion and Lysholm scores were similar among the three groups.

Conclusions: Despite its technical difficulty, the arthroscopic tibial inlay double-bundle technique is our preferred method of reconstruction of the posterior cruciate ligament because it stabilizes posterior tibial translation better than do the other two methods.

Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.

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