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Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons.
Arthroscopy. 2009 Jul; 25(7):777-82.A

Abstract

PURPOSE

The purpose of this study was to evaluate the results of double-bundle posterior cruciate ligament (PCL) reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons.

METHODS

Twenty-two cases of isolated chronic PCL rupture were reconstructed arthroscopically with 8 strands of autogenous hamstring tendons in a double-bundle and 4-tunnel manner. Quadruple-stranded semitendinosus tendon graft and quadruple-stranded gracilis tendon graft were used to reconstruct the anterolateral bundle and posteromedial bundle, respectively. The grafts were fixed by use of a non-hardware suspension fixation technique.

RESULTS

Nineteen patients were followed up for a minimum of 2 years. Before surgery, 15 patients had a 2+ posterior drawer test (PDT) and 4 patients had a 3+ PDT. At a minimum of 2 years after surgery, 17 patients (89.5%) had a negative PDT, 1 patient (5.3%) had a 1+ PDT, and 1 patient (5.3%) had a 2+ PDT. The mean KT-1000 examination results (MEDmetric, San Diego, CA) changed from 9.4 +/- 1.8 mm preoperatively to 1.0 +/- 1.0 mm postoperatively (P < .001). The stress radiography results changed from 10.6 +/- 2.0 mm preoperatively to 2.0 +/- 1.2 mm postoperatively (P < .001). According to the International Knee Documentation Committee knee examination form, the results were graded as normal in 15 patients (78.9%), nearly normal in 3 patients (15.8%), and abnormal in 1 patient (5.3%). The International Knee Documentation Committee subjective results increased from 65.6 +/- 5.1 to 92.1 +/- 3.7 (P < .001), and the Lysholm score increased from 63.5 +/- 4.9 to 92.5 +/- 4.1 (P < .001). The Tegner score was 5.1 before surgery and 6.3 at the last follow-up on average.

CONCLUSIONS

The results of this study showed that arthroscopic double-bundle PCL reconstruction by use of a non-hardware suspension suture fixation technique and 8 strands of autogenous hamstring tendons can yield normal results in 78.9% of patients and nearly normal results in 15.8% at a minimum of 2 years.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

Authors+Show Affiliations

Department of Joint Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China. hebeichenbaicheng@163.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19560642

Citation

Chen, Baicheng, and Shijun Gao. "Double-bundle Posterior Cruciate Ligament Reconstruction Using a Non-hardware Suspension Fixation Technique and 8 Strands of Autogenous Hamstring Tendons." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 25, no. 7, 2009, pp. 777-82.
Chen B, Gao S. Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. Arthroscopy. 2009;25(7):777-82.
Chen, B., & Gao, S. (2009). Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 25(7), 777-82. https://doi.org/10.1016/j.arthro.2009.01.017
Chen B, Gao S. Double-bundle Posterior Cruciate Ligament Reconstruction Using a Non-hardware Suspension Fixation Technique and 8 Strands of Autogenous Hamstring Tendons. Arthroscopy. 2009;25(7):777-82. PubMed PMID: 19560642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. AU - Chen,Baicheng, AU - Gao,Shijun, PY - 2008/06/21/received PY - 2008/12/18/revised PY - 2009/01/19/accepted PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/9/16/medline SP - 777 EP - 82 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 - 25 IS - 7 N2 - PURPOSE: The purpose of this study was to evaluate the results of double-bundle posterior cruciate ligament (PCL) reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. METHODS: Twenty-two cases of isolated chronic PCL rupture were reconstructed arthroscopically with 8 strands of autogenous hamstring tendons in a double-bundle and 4-tunnel manner. Quadruple-stranded semitendinosus tendon graft and quadruple-stranded gracilis tendon graft were used to reconstruct the anterolateral bundle and posteromedial bundle, respectively. The grafts were fixed by use of a non-hardware suspension fixation technique. RESULTS: Nineteen patients were followed up for a minimum of 2 years. Before surgery, 15 patients had a 2+ posterior drawer test (PDT) and 4 patients had a 3+ PDT. At a minimum of 2 years after surgery, 17 patients (89.5%) had a negative PDT, 1 patient (5.3%) had a 1+ PDT, and 1 patient (5.3%) had a 2+ PDT. The mean KT-1000 examination results (MEDmetric, San Diego, CA) changed from 9.4 +/- 1.8 mm preoperatively to 1.0 +/- 1.0 mm postoperatively (P < .001). The stress radiography results changed from 10.6 +/- 2.0 mm preoperatively to 2.0 +/- 1.2 mm postoperatively (P < .001). According to the International Knee Documentation Committee knee examination form, the results were graded as normal in 15 patients (78.9%), nearly normal in 3 patients (15.8%), and abnormal in 1 patient (5.3%). The International Knee Documentation Committee subjective results increased from 65.6 +/- 5.1 to 92.1 +/- 3.7 (P < .001), and the Lysholm score increased from 63.5 +/- 4.9 to 92.5 +/- 4.1 (P < .001). The Tegner score was 5.1 before surgery and 6.3 at the last follow-up on average. CONCLUSIONS: The results of this study showed that arthroscopic double-bundle PCL reconstruction by use of a non-hardware suspension suture fixation technique and 8 strands of autogenous hamstring tendons can yield normal results in 78.9% of patients and nearly normal results in 15.8% at a minimum of 2 years. LEVEL OF EVIDENCE: Level IV, therapeutic case series. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/19560642/Double_bundle_posterior_cruciate_ligament_reconstruction_using_a_non_hardware_suspension_fixation_technique_and_8_strands_of_autogenous_hamstring_tendons_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(09)00077-2 DB - PRIME DP - Unbound Medicine ER -