Abstract
The posterior cruciate ligament index (PCL index) has been reported as a diagnostic and prognostic marker for anterior cruciate ligament (ACL) reconstruction. The clinical relevance of PCL index on the reconstruction of ACL with hamstring tendon autograft has not been described in the literature. The objective of this study is to evaluate the importance of the PCL index as a marker of anatomic reconstruction and of functional improvement of patients undergoing ACL reconstruction with HT autograft. Twenty-four patients were submitted to ACL reconstruction with HT autograft. The PCL index was assessed by magnetic resonance imaging before and after surgery. The functional evaluation was performed through the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form© and Knee Society Knee Scoring System© (IKS). Patients presented a significant positive variation of the PCL index, IKDC and IKS scores. There is no significant correlation between PCL index variation and IKDC and IKS scores (p > 0.05). Unlike other studies reporting a relationship between the PCL index, control of rotational kinematics, and functional improvement in patients undergoing ACL reconstruction with bone-patellar tendon-bone autograft, this study does not demonstrate this association. There is evidence in this study to show that the PCL index may be used as an anatomic reconstructive marker of ACL but not to predict the clinical outcome in this type of reconstruction.
Highlights
Trauma of the knee is frequent and can affect about 1080 / 100.000 people[1]
The studies that evaluate the relation between posterior cruciate ligament (PCL) variation and anterior cruciate ligament (ACL) reconstruction were with bonepatellar tendon-bone autograft (BPTB)
The importance of this study is to evaluate the direct relationship between the PCL index, its variation and postoperative joint function in patients undergoing ACL reconstruction with hamstring tendon (HT) autograft
Summary
Trauma of the knee is frequent and can affect about 1080 / 100.000 people[1]. The rupture of the anterior cruciate ligament (ACL) has a variable incidence and can affect 8 to 80 / 100.000 people[2,3,4]. ACL is a fibrous bundle composed of dense connective tissue[11] and is based on two bundles, one anteromedial and one posterolateral[11,12,13] This ligament has as main function to be a restrictor of the anterior translation of the tibia and as a secondary function to give stability on the external or internal rotation, valgus or varus stress[14,15]. This index was proposed as a preoperative diagnostic method[19,20,21] or as a postoperative clinical[22] and imaging evaluation[23]. The objective of this study is to evaluate the clinical importance of the PCL index in patients undergoing reconstruction of the ACL with hamstring tendon (HT) autograft
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