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Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study.
Am J Sports Med. 2009 Aug; 37(8):1499-507.AJ

Abstract

BACKGROUND

Little is known about the parameters that influence the long-term results of isolated arthroscopically assisted reconstructions of the anterolateral bundle of the posterior cruciate ligament (PCL).

HYPOTHESIS

Chondrosis, time interval from injury to surgery, and graft choice significantly influence the long-term results of single-bundle PCL reconstructions.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Between 1995 and 2001, 22 male and 3 female patients with a mean age of 30.8 years (range, 17-52) underwent an anterolateral bundle reconstruction of the PCL for functional instability and pain. Nine were treated with a bone-patellar tendon-bone autograft (BPTB), 15 with a semitendinosus gracilis (STG) autograft, and 1 with an Achilles tendon allograft. Twenty-two patients were clinically and radiographically reviewed at a mean follow-up of 9.1 years (range, 6.5-12.6). Three patients were interviewed by telephone. Thirteen patients had chondrosis at time of surgery. The mean time from injury to surgery was 1.5 years.

RESULTS

The mean final International Knee Documentation Committee (IKDC), Lysholm, and functional visual analog scale (VAS) scores (65, 75, and 8, respectively) were fair to good and were significantly better than preoperatively (38, 50, and 4, respectively) (P < .001). The final Tegner (5.7) score was significantly lower than the preinjury score (7.2) (P < .001). The mean anteroposterior laxity measured by KT-1000 arthrometer and Telos stress radiographs was significantly increased on the operated side (mean side-to-side difference of 2.1 mm and 4.7 mm, respectively). The functional scores were not significantly different between the BPTB and STG reconstructions. Patients without chondrosis at time of surgery and patients operated within the first year from injury had significantly better functional results at final follow-up (P < .05).

CONCLUSION

Arthroscopically assisted reconstructions of the anterolateral bundle of the PCL in patients with symptomatic isolated grade II to IV PCL-deficient knees lead to significantly improved functional results at long term if there is no cartilage damage at time of surgery. Nonoperative treatment should not be extended more than 1 year from injury. Graft choice did not significantly influence the functional outcome at long term.

Authors+Show Affiliations

Catholic University Hospitals, Leuven, Belgium. stijnhermans@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19451096

Citation

Hermans, Stijn, et al. "Long-term Results of Isolated Anterolateral Bundle Reconstructions of the Posterior Cruciate Ligament: a 6- to 12-year Follow-up Study." The American Journal of Sports Medicine, vol. 37, no. 8, 2009, pp. 1499-507.
Hermans S, Corten K, Bellemans J. Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. Am J Sports Med. 2009;37(8):1499-507.
Hermans, S., Corten, K., & Bellemans, J. (2009). Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. The American Journal of Sports Medicine, 37(8), 1499-507. https://doi.org/10.1177/0363546509333479
Hermans S, Corten K, Bellemans J. Long-term Results of Isolated Anterolateral Bundle Reconstructions of the Posterior Cruciate Ligament: a 6- to 12-year Follow-up Study. Am J Sports Med. 2009;37(8):1499-507. PubMed PMID: 19451096.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. AU - Hermans,Stijn, AU - Corten,Kristoff, AU - Bellemans,Johan, Y1 - 2009/05/17/ PY - 2009/5/20/entrez PY - 2009/5/20/pubmed PY - 2009/11/18/medline SP - 1499 EP - 507 JF - The American journal of sports medicine JO - Am J Sports Med VL - 37 IS - 8 N2 - BACKGROUND: Little is known about the parameters that influence the long-term results of isolated arthroscopically assisted reconstructions of the anterolateral bundle of the posterior cruciate ligament (PCL). HYPOTHESIS: Chondrosis, time interval from injury to surgery, and graft choice significantly influence the long-term results of single-bundle PCL reconstructions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 1995 and 2001, 22 male and 3 female patients with a mean age of 30.8 years (range, 17-52) underwent an anterolateral bundle reconstruction of the PCL for functional instability and pain. Nine were treated with a bone-patellar tendon-bone autograft (BPTB), 15 with a semitendinosus gracilis (STG) autograft, and 1 with an Achilles tendon allograft. Twenty-two patients were clinically and radiographically reviewed at a mean follow-up of 9.1 years (range, 6.5-12.6). Three patients were interviewed by telephone. Thirteen patients had chondrosis at time of surgery. The mean time from injury to surgery was 1.5 years. RESULTS: The mean final International Knee Documentation Committee (IKDC), Lysholm, and functional visual analog scale (VAS) scores (65, 75, and 8, respectively) were fair to good and were significantly better than preoperatively (38, 50, and 4, respectively) (P < .001). The final Tegner (5.7) score was significantly lower than the preinjury score (7.2) (P < .001). The mean anteroposterior laxity measured by KT-1000 arthrometer and Telos stress radiographs was significantly increased on the operated side (mean side-to-side difference of 2.1 mm and 4.7 mm, respectively). The functional scores were not significantly different between the BPTB and STG reconstructions. Patients without chondrosis at time of surgery and patients operated within the first year from injury had significantly better functional results at final follow-up (P < .05). CONCLUSION: Arthroscopically assisted reconstructions of the anterolateral bundle of the PCL in patients with symptomatic isolated grade II to IV PCL-deficient knees lead to significantly improved functional results at long term if there is no cartilage damage at time of surgery. Nonoperative treatment should not be extended more than 1 year from injury. Graft choice did not significantly influence the functional outcome at long term. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/19451096/Long_term_results_of_isolated_anterolateral_bundle_reconstructions_of_the_posterior_cruciate_ligament:_a_6__to_12_year_follow_up_study_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546509333479?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -