Biomechanical Evaluation of an Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction

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• 作者：Harehiko Tsukada ; M.D. ; ^{hare1018@cc.hirosaki-u.ac.jp} ; Yasuyuki Ishibashi ; M.D. ; Eiichi Tsuda ; M.D. ; Akira Fukuda ; M.D. ; Yuji Yamamoto ; M.D. ; Satoshi Toh ; M.D.
• 刊名：Arthroscopy: The Journal of Arthroscopic & Related Surgery
• 出版年：2012
• 出版时间：February, 2012
• 年：2012
• 卷：28
• 期：2
• 页码：264-271
• 全文大小：590 K

文摘

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Purpose

The purpose of this study was to evaluate the effect of the anatomic double-bundle reconstruction (ADBR) of the posterior cruciate ligament (PCL) with 2 femoral tunnels and 2 tibial tunnels.

Methods

Eight fresh-frozen human knees were used. Bone tunnels were created based on the PCL anatomic footprints. A 9-mm looped semitendinosus and gracilis tendon for anterolateral bundle reconstruction (ALR), a 7-mm looped semitendinosus tendon for posteromedial bundle reconstruction (PMR), and the same grafts for the ADBR were used. Under a 100-N posterior tibial load and under a 100-N posterior tibial load and 5 Nm of external tibial torque, the posterior tibial translation (PTT) was measured.

Results

Under posterior tibial load, at 0¡ã, the PTT of the ALR was larger than that of the intact knee (P = .04) and the ADBR (P = .03); however, there were no significant differences between the PTT of the PMR and that of the ADBR (P = .28) and intact knee (P = .99). At 30¡ã, the PTT of the ADBR was smaller than that of the ALR (P = .02) and PMR (P = .02). At 60¡ã, the PTT of the PMR was larger than that of the ADBR (P = .02). At 90¡ã, the PTT of the PMR was larger than that of the ADBR (P = .02). Under posterior tibial load and external tibial torque, at 0¡ã, the PTT of the ALR was larger than that of the ADBR (P = .04).

Conclusions

Although the graft size of the ADBR was larger than other reconstructions, the ADBR was better than the ALR at 0¡ã and 30¡ã of knee flexion under the posterior tibial load and at 0¡ã under the combination of posterior tibial load and external tibial torque, as well as better than the PMR at 30¡ã, 60¡ã, and 90¡ã of knee flexion under the posterior tibial load.

Clinical Relevance

The clinical outcome of PCL reconstruction might improve by reducing posterior knee laxity in knee extension with the ADBR.