[Reconstruction of posterior cruciate ligament using bone-patellar tendon-bone autograft].

OBJECTIVE

To introduce the surgical procedures of posterior cruciate ligament (PCL) reconstruction using bone-patellar tendon-bone autograft and to evaluate the clinical effect of treatment of posterior instability.

METHODS

Twenty cases of chronic instability of knee secondary to rupture of PCL underwent reconstruction of PCL using free autograft of bone-patellar tendon-bone by isometric tibial and femoral attachment through anterior approach of knee. Larson knee function score, patient subjective evaluation and physical testing were used to evaluate the effect of this procedure.

RESULTS

In this series, the average point of Larson score was 62 preoperatively. By the period of 6 - 58 month follow-up, the average point was 92. Subjectively 18 cases showed satisfactory results. Lachmann test showed negative results in all cases. The range of motion was 115 degrees on the average.

CONCLUSIONS

This method can provide a strong and stable PCL replacement. But the surgical procedure is more difficult than ACL reconstruction. Some factors for a successful operation include evaluation of instability, preparation of graft material, internal fixation of graft, isometric attachment, reconstruction of other structures of knee, and bearing tension of graft.