Abstract
Posterior cruciate ligament (PCL) reconstruction can be performed using single bundle (SB) and double bundle (DB) techniques. The present study investigated whether DB PCL reconstruction is superior to SB reconstruction in terms of patient reported outcome measures (PROMs) and joint stability. In December 2021 Embase, Google Scholar, Pubmed, Scopus databases were accessed. All clinical trials comparing SB versus DB reconstruction to address PCL insufficiency in skeletally mature patients were considered. Data from 483 procedures were retrieved. The mean follow-up was 31.0 (28.0 to 107.6) months, and the mean timespan between injury and surgery was 11.3 (6 to 37) months. The mean age of the patients was 29.3 ± 3.8 years. 85 of 483 patients (18%) were women. At a mean of 31.0 months post reconstruction, ROM (P = 0.03) was slightly greater in the SB group, while the Tegner score (P = 0.03) and the Telos stress (P = 0.04) were more favorable in the DB cohort. Similarity was found in instrumental laxity (P = 0.4) and Lysholm score (P = 0.3). The current evidence does not support the use of DB techniques for PCL reconstruction. Both methods could restore knee stability and motion with satisfactory short term patient reported outcome measures. Further high quality clinical trials are required to validate these results on a larger scale.
Highlights
The posterior cruciate ligament (PCL) restrains posterior tibial translation, preventing external rotation of the tibia[1,2]
A meta-analysis was conducted to investigate whether double bundle (DB) Posterior cruciate ligament (PCL) reconstruction is superior to the single bundle (SB) technique in terms of patient reported outcome measures (PROMs) and joint stability
Our results indicated that the Tegner score and the results of the Telos stress were favorable in to the DB cohort; the clinical impact of these differences was minimal
Summary
The posterior cruciate ligament (PCL) restrains posterior tibial translation, preventing external rotation of the tibia[1,2]. The PCL inserts on the intercondylar eminence of the tibia through an anterolateral and a posteromedial bundle[1,2] These bundles have distinct fibres orientation and tensioning patterns throughout the range of motion of the k nee[3–6]. On the other hand, when both bundles are injured, the PCL can no longer stabilize the joint, and, if clinical evident instability develops, surgical reconstruction may be indicated[15–19]. Both single bundle (SB) and double bundle (DB) techniques for PCL reconstruction have been described[20–23]. DB reconstruction better restores the antero-posterior stability than SB techniques[24,25] It is unclear whether DB PCL reconstruction results in better stability and patient reported outcome measures (PROMs) than the SB technique[26–43]. Though DB PCL reconstruction is believed to achieve better knee biomechanics, it does not results in better outcomes following reconstruction of the PCL
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