Arthroscopic posterior cruciate ligament reconstruction with bone-tendon-bone patellar graft

Abstract

We present a retrospective study of 24 patients with chronic injury of the posterior cruciate ligament (PCL) treated by arthroscopically assisted reconstruction with bone-tendon-bone patellar autograft. At a mean follow-up of 26.5 months (range 24–53 months) the International Knee Documentation Committee (IKDC) evaluation form, Lysholm and Tegner rating systems were used to evaluate symptoms, functional limitations during sports and daily activities, and changes in activity level. At the final IKDC evaluation we found 6 patients (25%) with grade A (normal), 13 patients (54.2%) with grade B (nearly normal), 3 patients (12.5%) with grade C (abnormal) and 2 patients (8.3%) with grade D (severely abnormal). The average side-to-side difference, as measured by the KT-2000 arthrometer, was 8.38 (± 1.95) preoperatively and 4.08 (± 2.09) mm postoperatively at 89 N with the knee flexed at a neutral quadriceps knee angle of approximately 70°. The worst results significantly correlated with the time elapsed from injury to surgery (P < 0.001). The preoperative Lysholm score was 56 ± 12 (range 41–79) and at follow-up 94 ± 8 (range 76–100). The Tegner activity score improved for all patients after surgical treatment. Average preinjury score was 7.4 (range 4–9), decreasing to 3.40 (range 2–7) preoperatively and increasing to 5.4 (range 4–9) postoperatively. At follow-up, 12 patients (50%) regained to their preinjury scores after surgery. Our study suggests that this arthroscopic technique, which allows a more precise placement of tunnels, can improve the results of the PCL reconstruction with a bone-tendon-bone autograft.