Simultaneous Double-Bundle Anterior Cruciate Ligament and Posterior Cruciate Ligament Reconstruction With Autogenous Hamstring Tendons

Abstract

The purpose of this study was to evaluate the clinical results of simultaneous double-bundle anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction. We performed arthroscopic reconstruction in 21 cases of combined ACL/PCL rupture, 14 chronic and 7 acute, with autogenous hamstring tendons in 1 stage, both in a double-bundle and 4-tunnel manner. The semitendinosus tendon and gracilis tendon from the uninjured leg were used to make two 4-stranded grafts to reconstruct the PCL, and those from the injured leg were used to make two 4-stranded grafts to reconstruct the ACL. The grafts were suspended with a mini-plate and buttons. The patients were followed up for a minimum of 2 years and evaluated according to the International Knee Documentation Committee (IKDC) and Lysholm rating scale. The anterior-posterior knee laxity was assessed by KT-1000 examination (MEDmetric, San Diego, CA). At the last follow-up, all patients showed normal knee extension. One patient had a 10 degrees flexion limitation, and four had a 5 degrees flexion limitation. KT-1000 examination showed that the side-to-side difference in overall anterior-posterior laxity at 70 degrees flexion was 0 to 2 mm in 16 patients, 3 to 5 mm in 4 patients, and 6 to 10 mm in 1 patient; the side-to-side difference in overall anterior-posterior laxity at 25 degrees flexion was 0 to 2 mm in 14 patients, 3 to 5 mm in 6 patients, and 6 to 10 mm in 1 patient. The IKDC subjective, Lysholm, and Tegner scores were 85.5 +/- 5.8, 91.9 +/- 4.2, and 5.0 +/- 1.9, respectively. According to the last IKDC evaluation, the results were graded as normal in 13 patients (61.9%), nearly normal in 7 patients (33.3%), and abnormal in 1 patient (4.8%). Simultaneous double-bundle ACL and PCL reconstruction with autogenous hamstring tendons can yield normal results in 61.9% of patients and nearly normal results in 33.3% at a minimum of 2 years. Level IV, therapeutic case series.