Double-bundle PCL reconstruction using autologous hamstring tendons: outcome with a minimum 2-year follow-up

Abstract

ObjectiveTo present the outcomes of posterior cruciate ligament (PCL) double-bundle reconstruction using autologous hamstring tendons, with a minimum follow-up of two years.MethodsEvaluation of 16 cases of PCL injury that underwent double-bundle reconstruction with autogenous hamstring tendons, between 2011 and 2013. The final sample consisted of 16 patients, 15 men and one woman, with a mean age of 31 years (21–49). The predominant mechanism was motorcycle accident in half of the cases. There was a mean interval of 15 months between the time of lesion and the surgery (three to 52 months). Five lesions were isolated and 11, associated. Clinical evaluation, application of validated scores, and measurements with use of the KT-1000 were performed.ResultsThe analysis showed a mean preoperative Lysholm score of 50 points (28–87), progressing to 94 points (85–100) postoperatively. The IKDC score also demonstrated improvement. In the preoperative evaluation, four and 12 patients were respectively classified as C (abnormal) and D (very unusual), and in the postoperative evaluation six as A (normal) and ten as B (close to normal). In the post-operative evaluation by KT1000 arthrometer, 13 patients showed difference between 0–2 mm and 3 between 3 and 5 mm, when compared with the contralateral side.ConclusionAutologous hamstring tendons are a viable option in double-bundle reconstruction of the PCL, with good clinical results in a minimum follow-up of two years.

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

“…To date, there is no consensus with regard to the graft choice for primary PCL reconstruction, and the graft source relates to the surgeon preferences. Different autografts have been used for PCL reconstruction [5, 8–11, 14–16, 18, 20, 24, 35, 42, 44, 51, 62]. Setyawan et al [51] described PCL reconstruction using peroneus longus tendon autograft with good functional outcomes and preservation of ankle function at 2 years follow‐up.…”

“…Semitendinosus, gracilis, bone–patellar tendon–bone (BPTB), and quadriceps autografts are commonly used for PCL reconstruction [5, 8–11, 14–16, 18, 20, 24, 35, 42, 44, 51, 62]. Among allografts, given its length and thickness, the Achilles tendon is commonly employed for PCL reconstruction [31].…”

Onlay Technique for Posterior Cruciate Ligament Reconstruction: The Paccola's Technique

“…Since it is not a frequent injury, with low prevalence compared with the ACL reconstruction surgery, most surgeons are not familiar with its surgical technique. 22 …”

Posterior Cruciate Ligament Reconstruction: Are the Results Similar to Anterior Cruciate Ligament Reconstruction?

“…All cases included were operated by the same surgeon (R.P.L.C.). The transtibial technique in femoral double bundle 11 )- ( 13 with autologous quadriceps and semitendinosus grafts from patients’ ipsilateral knees or bilateral flexor tendons were used in PCL reconstructions (group 1), whereas the “outside-in” ( 14 technique with autografts from ipsilateral flexor tendons was used in ACL reconstructions (group 2). If grafts only included flexor tendons, anterolateral bundles were reconstructed with two semitendinosus grafts and posteromedial ones with two gracilis ones.…”