Vierjahresergebnisse nach isolierter hinterer Kreuzbandrekonstruktion in Einbündeltechnik

Abstract

The purpose of this study was to evaluate the clinical and radiological results after isolated reconstruction of the posterior cruciate ligament (PCL) using semitendinosus (ST) and gracilis (GT) tendon grafts with the arthroscopic single-bundle technique. Following PCL reconstruction using the single-bundle technique performed between 2002 and 2005, 14 patients (2 women, 12 men) prospectively underwent a standardized follow-up examination after an average postoperative time of 4 years. All patients included in this study had isolated insufficiency of the PCL and symptomatic instability. The exclusion criteria were the presence of a complex knee joint instability and the implementation of additional stabilizing measures or another method of PCL reconstructive surgery. The mean follow-up time was 47.2 ± 8.7 months. Preoperative and postoperative stress radiographs were taken using the Telos stress instrument in order to evaluate the posterior translation. Knee joint function and degree of activity were recorded using the Tegner activity score, the subjective IKDC score and the overall IKDC score. The posterior tibial translation of 10.1 ± 1.7 mm had an overall average improvement to a postoperative value of 4.6 ± 2.3 mm (p < 0.001). The patients showed a significant improvement in the Tegner activity score from an average 2.7 ± 0.8 points to 5.7 ± 1.3 points (p < 0.001). Evaluation of the subjective IKDC showed a significant improvement from a preoperative score of 41.32 ± 11.23 points to a postoperative score of 65.08 ± 13.51 points (p < 0.001). In total, 10 patients (71.5%) exhibited a normal or nearly normal outcome. According to the objective IKDC score, 4 patients (28.5%) were categorized as moderate. The above mentioned reconstruction technique can achieve a stable knee function in patients with isolated PCL insufficiency. The isolated single-bundle PCL reconstruction offers a medium-term improvement regarding the activity level and stability of the knee joint.