Endoscopic single-bundle posterior cruciate ligament reconstruction: results at minimum 2-year follow-up |
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| Institution: | 1. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph''s Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ 85013, USA;2. Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph''s Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ 85013, USA;3. Division of Orthopedic Surgery, San Diego Spine Foundation, Scripps Clinic, La Jolla, CA, USA;1. NYU Medical Center—Hospital for Joint Diseases, 301 E 17th St, New York, NY 10003, USA;2. Rocky Mountain Spine, 1601 E 19th Ave, Denver, CO 80218, USA;3. Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA;4. University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA;5. Oregon Health and Science University, 3303 SW Bond Ave, Portland, OR 97239, USA;6. University of Kansas, 1450 Jayhawk Blvd, Kansas City, KS 66045,USA;1. College of Veterinary Medicine, China Agricultural University, Beijing 100193, China;2. College of Veterinary Medicine, Yunnan Agricultural University, Kunming 650201, China;3. College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhehot 010018, China;4. Beijing Puren Ecological Technology CO., LTD, 102200, China;5. College of Veterinary Medicine, China Agricultural University, Yuan Ming Yuan West Road No. 2, Haidian District, Beijing 100193, China |
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| Abstract: | Purpose:The goal of this study was to evaluate the clinical outcome of single-bundle posterior cruciate ligament (PCL) reconstruction with retention of the PCL remnant and hamstring tendon autograft with interference screw fixation in patients with isolated PCL laxity.Type of Study:Prospective case series with minimum 2-year follow-up evaluation.Methods:Thirty-one patients for whom conservative management had failed underwent surgery using a 4-strand hamstring tendon autograft with interference screw fixation. The median time from injury to reconstructive surgery was 9 months (range, 4 to 120 months). At a minimum of 2 years after surgery, patients were assessed with the International Knee Documentation Committee (IKDC) Knee Ligament evaluation, Lysholm knee score, and KT-1000 instrumented testing.Results:Before surgery, the median Lysholm knee score was 64 (95% confidence interval, 51 to 67). No patient rated knee function as normal, and all patients showed at least grade 2 posterior drawer laxity. At review, the median Lysholm knee score was 94 (95% confidence interval, 83 to 94), 56% rated the knee as normal and only one patient was found to exhibit grade 2 laxity on posterior drawer testing. Before injury, 94% of patients participated in moderate or strenuous activity. This figure fell to 26% after injury and had increased to 63% at review.Conclusions:Endoscopic reconstruction of PCL laxity using single-bundle 4-strand hamstring tendon autograft, without removal of the PCL stump, provides a significant reduction in knee symptoms and allows 63% of patients to return to moderate or strenuous activity. This is an effective procedure for symptomatic patients who have isolated PCL laxity and for whom conservative management has failed. |
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