Curative effect analysis of arthroscopic transtibial single-bundle posterior cruciate ligament residual reconstruction using artificial ligament compared with hamstring tendon autograft

Abstract

Objective To compare the curative effect of arthroscopic transtibial single-bundle posterior cruciate ligament(PCL) reconstruction using LARS artificial ligament and hamstring tendon autograft. Methods Thirty-seven patients who underwent isolated single-bundle PCL reconstruction with remnant preservation technique were evaluated.They were divided into LARS group(n=19) and 4-strand hamstring tendon autograft(4SHG) group(n=18). Minimum follow-up was 2 years.Patients were evaluated preoperatively and postoperatively at the latest follow-up with several parameters, including the international knee documentation committee(IKDC) score, Lysholm knee score, Tegner activity rating and physical examination. Results After operation, in LARS group, Lysholm sorce was 89(51, 100) points, Tegner sorce was 6(1, 9) points, IKDC sorces were normal of 5 cases, nearly normal of 10 cases, abnormal of 3 cases, and obviously abnormal of 1 case, significantly improved compared with before operation(62(28, 98) points, 2(1, 5) points, abnormal IKDC score of 8 cases, obviously abnormal of 11 cases; P<0.001). In 4SHG group, Lysholm sorce was 84(36, 100) points, Tegner sorce was 6(1, 9) points, IKDC sorces were normal of 5 cases, nearly normal of 9 cases, abnormal of 3 cases, and obviously abnormal of 1 case, better than before operation(64(28, 98) points, 2(1, 5) points, IKDC score abnormal of 8 cases, obviously abnormal of 10 cases; P<0.001). There was significant difference about Lysholm sorce between two groups after operation(P=0.037). The drawer test results show that, after operation, there were 15 case of grade 0, 4 cases of grade 1 in LARS group, 3 cases of grade 0, 11 cases of grade 1, 4 cases of grade 2 in 4SHG group, all improved significantly compared with before operation, and the differences were statistically significant(LARS group: χ2=38.000, P<0.001; 4SHG group: χ2=29.143, P<0.001), and the grade of patients in LARS group were superior to 4SHG group after operation(χ2=15.251, P<0.001). Conclusion The clinical effect of using a LARS ligament for PCL reconstruction is more useful than using a 4SHG. Key words: Posterior cruciate ligament; Arthroscopy; LARS artificial ligament; Hamstring tendon