Posterior cruciate ligament reconstruction combined with knee posterolateral complex reconstruction.

Abstract

Objective To introduce the method of posterior cruciate ligament (PCL) reconstruction combined with knee posterolateral complex (PLC) reconstruction through arthroseopy and to evaluate short-term outcomes. Methods Twenty cases of combined PCL and PLC injuries were treated with two-bundle PCL reconstruction with eight strands of autogenous hamstring tendons and PLC reinforcement with autoge-nous semitendinosns tendon. The semitendinosus tendon and gracilis tendon from the uninjured lower limb were harvested to reconstruct PCL, and the semitendinosus tendon from the injured leg was used to reinforce PLC. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. The patients were followed up for more than one year and evaluated according to IKDC, Lysholm and Tegner rating scales.Results At the last follow-up, all patients showed normal knee extension. One patient had 15°of flexion limitation, and five had 5° of flexion limitation. Posterior drawer test were negative in 17 patients, grade Ⅰpositive in 2, and grade Ⅱ positive in one patient. KT-1000 examination averaged (2.35±1.35) ram. Varusstress test showed less than 5 mm increase of lateral patellofemoral joint space in 18 patients at 30° flexionof knee joint, 5 mm and 6 mm increase was noted only in one respective patient. External rotation examina- tion showed less than 5° increase in all eases compared with the intact knee,with an average of 2.10°±2.67°.IKDC subjective, Lysholm, and Tegner scores were 90.00±3.49, 91.90±2.57 and 6.50±0.69 respectively. Ac-cording to objective IKDC evaluation, the results were graded as normal in 15 patients (75%), nearly normal in 4 (20%), and abnormal in 1 patient (5%). Conclusion Two-bundle PCL reconstruction with eight strands of hamstring tendons, combined with PLC reinforcement can reliably restore knee stability. Key words: Knee joint; Posterior cruciate ligament; Reconstructive surgery procedures; Arthroscopy