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Double-bundle posterior cruciate ligament reconstruction with allograft tissue: 2-year postoperative outcomes.
Knee Surg Sports Traumatol Arthrosc. 2002 Sep; 10(5):274-9.KS

Abstract

In addition to minimizing graft site morbidity, providing stable fixation, and enabling early progressive rehabilitation, the ideal PCL reconstruction would closely simulate natural ligament function. This study retrospectively examined the 2-year postoperative outcomes of 19 athletically active patients referred with clinically symptomatic PCL-deficient knees. Preoperatively 18 patients had severely abnormal knee ligament examination scores, and one had an abnormal score (IKDC). All but one patient was confirmed negative for observable posterolateral corner injury via MRI. Eighteen patients had clinical evidence of posterolateral instability. All patients underwent double-bundle PCL reconstruction (using allograft tissue) without concomitant posterolateral corner reconstruction. Two years after surgery 100% of patients had normal (n=18) or near normal (n=1) passive knee joint motion. The results were: one-leg hop test, 58% normal, 37% nearly normal, 5% abnormal; knee ligament examination, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; knee arthrometry, 2.4+/-2 mm posterior tibial displacement; IKDC subjective assessment section, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; IKDC symptom-activity level section, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; final knee ligament evaluation, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; Lysholm knee scoring scale, 63% excellent, 27% good, 5% fair and 5% poor. Improved stability with clinical ligamentous laxity tests and good IKDC subjective and symptom-activity results 2 years after surgery suggest that for patients with PCL rupture and grade I or II posterolateral instability the double-bundle procedure alone sufficiently restores PCL function through a greater range of knee motion than traditional single-bundle techniques.

Authors+Show Affiliations

Division of Sports Medicine, Department of Orthopedic Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY 40202, USA. john.nyland@louisville.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12355300

Citation

Nyland, John, et al. "Double-bundle Posterior Cruciate Ligament Reconstruction With Allograft Tissue: 2-year Postoperative Outcomes." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 10, no. 5, 2002, pp. 274-9.
Nyland J, Hester P, Caborn DN. Double-bundle posterior cruciate ligament reconstruction with allograft tissue: 2-year postoperative outcomes. Knee Surg Sports Traumatol Arthrosc. 2002;10(5):274-9.
Nyland, J., Hester, P., & Caborn, D. N. (2002). Double-bundle posterior cruciate ligament reconstruction with allograft tissue: 2-year postoperative outcomes. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 10(5), 274-9.
Nyland J, Hester P, Caborn DN. Double-bundle Posterior Cruciate Ligament Reconstruction With Allograft Tissue: 2-year Postoperative Outcomes. Knee Surg Sports Traumatol Arthrosc. 2002;10(5):274-9. PubMed PMID: 12355300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Double-bundle posterior cruciate ligament reconstruction with allograft tissue: 2-year postoperative outcomes. AU - Nyland,John, AU - Hester,Peter, AU - Caborn,David N M, Y1 - 2002/06/28/ PY - 2001/11/01/received PY - 2002/04/25/accepted PY - 2002/10/2/pubmed PY - 2003/1/9/medline PY - 2002/10/2/entrez SP - 274 EP - 9 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 10 IS - 5 N2 - In addition to minimizing graft site morbidity, providing stable fixation, and enabling early progressive rehabilitation, the ideal PCL reconstruction would closely simulate natural ligament function. This study retrospectively examined the 2-year postoperative outcomes of 19 athletically active patients referred with clinically symptomatic PCL-deficient knees. Preoperatively 18 patients had severely abnormal knee ligament examination scores, and one had an abnormal score (IKDC). All but one patient was confirmed negative for observable posterolateral corner injury via MRI. Eighteen patients had clinical evidence of posterolateral instability. All patients underwent double-bundle PCL reconstruction (using allograft tissue) without concomitant posterolateral corner reconstruction. Two years after surgery 100% of patients had normal (n=18) or near normal (n=1) passive knee joint motion. The results were: one-leg hop test, 58% normal, 37% nearly normal, 5% abnormal; knee ligament examination, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; knee arthrometry, 2.4+/-2 mm posterior tibial displacement; IKDC subjective assessment section, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; IKDC symptom-activity level section, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; final knee ligament evaluation, 47% normal, 42% nearly normal, 5% abnormal, 5% severely abnormal; Lysholm knee scoring scale, 63% excellent, 27% good, 5% fair and 5% poor. Improved stability with clinical ligamentous laxity tests and good IKDC subjective and symptom-activity results 2 years after surgery suggest that for patients with PCL rupture and grade I or II posterolateral instability the double-bundle procedure alone sufficiently restores PCL function through a greater range of knee motion than traditional single-bundle techniques. SN - 0942-2056 UR - https://www.unboundmedicine.com/medline/citation/12355300/Double_bundle_posterior_cruciate_ligament_reconstruction_with_allograft_tissue:_2_year_postoperative_outcomes_ L2 - https://dx.doi.org/10.1007/s00167-002-0300-4 DB - PRIME DP - Unbound Medicine ER -