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Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons.
Arthroscopy. 2001 Jan; 17(1):88-97.A

Abstract

Recent biomechanical studies have shown that an anatomic double-bundle posterior cruciate ligament (PCL) reconstruction is superior in restoring normal knee laxity compared with the conventional single-bundle isometric reconstruction. We describe a modification of an endoscopic PCL reconstruction technique using a double-bundle Y-shaped hamstring tendon graft. A double- or triple-bundle semitendinosus-gracilis tendon graft is used and directly fixed with soft threaded biodegradable interference screws. In the medial femoral condyle, 2 femoral tunnels are created inside-out through a low anterolateral arthroscopic portal. First, in 80 degrees of flexion, the double-stranded gracilis graft is fixed with an interference screw inside the lower femoral socket, representing the insertion site of the posteromedial bundle. In full extension the combined semitendinosus-gracilis graft is pretensioned and fixed inside the posterior aspect of the single tibial tunnel. The double- or triple-stranded semitendinosus tendon is inserted in the higher femoral tunnel, presenting the insertion site of the anterolateral bundle. Finally, pretension is applied to the semitendinosus bundle in 70 degrees of flexion and a third screw is inserted. Using this technique, the stronger semitendinosus part of the double-bundle graft, which mimics the anterolateral bundle of the PCL, is fixed in flexion, whereas the smaller gracilis tendon part (posteromedial bundle) is fixed in full extension. Thus, a fully arthroscopic anatomic PCL reconstruction technique is available that may better restore normal knee kinematics as compared to the single-stranded isometric reconstruction.

Authors+Show Affiliations

Reconstructive Surgery, Sports Traumatology and Arthroscopy Service, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin. kruzlifix@staehelin.chNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

11154375

Citation

Stähelin, A C., et al. "Anatomic Double-bundle Posterior Cruciate Ligament Reconstruction Using Hamstring Tendons." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 17, no. 1, 2001, pp. 88-97.
Stähelin AC, Südkamp NP, Weiler A. Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy. 2001;17(1):88-97.
Stähelin, A. C., Südkamp, N. P., & Weiler, A. (2001). Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 17(1), 88-97.
Stähelin AC, Südkamp NP, Weiler A. Anatomic Double-bundle Posterior Cruciate Ligament Reconstruction Using Hamstring Tendons. Arthroscopy. 2001;17(1):88-97. PubMed PMID: 11154375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons. AU - Stähelin,A C, AU - Südkamp,N P, AU - Weiler,A, PY - 2001/1/12/pubmed PY - 2001/2/28/medline PY - 2001/1/12/entrez SP - 88 EP - 97 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 17 IS - 1 N2 - Recent biomechanical studies have shown that an anatomic double-bundle posterior cruciate ligament (PCL) reconstruction is superior in restoring normal knee laxity compared with the conventional single-bundle isometric reconstruction. We describe a modification of an endoscopic PCL reconstruction technique using a double-bundle Y-shaped hamstring tendon graft. A double- or triple-bundle semitendinosus-gracilis tendon graft is used and directly fixed with soft threaded biodegradable interference screws. In the medial femoral condyle, 2 femoral tunnels are created inside-out through a low anterolateral arthroscopic portal. First, in 80 degrees of flexion, the double-stranded gracilis graft is fixed with an interference screw inside the lower femoral socket, representing the insertion site of the posteromedial bundle. In full extension the combined semitendinosus-gracilis graft is pretensioned and fixed inside the posterior aspect of the single tibial tunnel. The double- or triple-stranded semitendinosus tendon is inserted in the higher femoral tunnel, presenting the insertion site of the anterolateral bundle. Finally, pretension is applied to the semitendinosus bundle in 70 degrees of flexion and a third screw is inserted. Using this technique, the stronger semitendinosus part of the double-bundle graft, which mimics the anterolateral bundle of the PCL, is fixed in flexion, whereas the smaller gracilis tendon part (posteromedial bundle) is fixed in full extension. Thus, a fully arthroscopic anatomic PCL reconstruction technique is available that may better restore normal knee kinematics as compared to the single-stranded isometric reconstruction. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/11154375/Anatomic_double_bundle_posterior_cruciate_ligament_reconstruction_using_hamstring_tendons_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(01)61249-0 DB - PRIME DP - Unbound Medicine ER -