Two-bundles posterior cruciate ligament reconstruction: Technique and results

Abstract

Posterior cruciate ligament (PCL) injuries do not seem to be well tolerated. None of the classical techniques give consistant results. The purpose of this study is to introduce an original procedure restoring both main bundles of the PCL by a short anterior approach or arthroscopically. Anterolateral and posteromedial bundles of the PCL are fundamentaly nonisometric. Therefore, a one bundle reconstruction is totaly unable to reproduce the biomechanics and provide normal anteroposterior and rotational stability. The reconstruction is made with a guide that allows safe and reproducable placement of a specially designed artificial ligament made of free fibers, resulting in a fast fibroblastic ingrowth. Postero lateral instability, which is often combined with the PCL insufficiency must be treated by a specific procedure. Many investigators feel that untreated PCL ruptures may induce severe cartilage damages and arthritis. Until now no autogenous plasty seems to be reliable. The use of an artifical ligament that induced no complications, and was precise, nondamaging, and offers quick rehabilitation made up our minds to perform early surgical repair of PCL injuries.