[Augmented reconstruction of the posterior cruciate ligament for acute and chronic posterior instability].

OBJECTIVE

Anatomical reconstruction of the posterior cruciate ligament (PCL) with suture tape augmentation to enhance primary stability.

INDICATIONS: Acute or chronic PCL ruptures, either isolated or as part of multiligamentous injuries, in cases of symptomatic instability or failure of conservative treatment.

CONTRAINDICATIONS: Fixed posterior drawer, active infection, bony avulsion.

SURGICAL TECHNIQUE: Supine positioning, use of standard portals for arthroscopic PCL reconstruction. Femoral and tibial tunnels are created using a targeting device following preparation of the insertion sites. The hamstring graft is augmented with nonresorbable suture tape. The augmentation suture is fixed separately using a suture anchor under continuous anterior drawer stress. Graft fixation is performed via extracortical device at the femur and with an interference screw at the tibia.

POSTOPERATIVE MANAGEMENT: Six weeks of extension bracing with posterior tibial support, worn 24 h/day, and 20 kg partial weight-bearing. This is followed by 6 weeks of continued mobile bracing with posterior tibial support and progressive mobilization and load increase, accompanied by physiotherapy.

RESULTS

Biomechanical and early clinical studies suggest promising benefits of augmentation for stability and function, though robust long-term data are still lacking.