Posterior cruciate ligament reconstruction with the quadriceps tendon in chronic injuries

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2002-09, Vol.10 (5), p.266-273
• Main Authors: Aglietti, Paolo, Buzzi, Roberto, Lazzara, Daniele
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adolescent; Adult; Collateral Ligaments - surgery; Female; Humans; Injuries; Knee; Knee Joint - surgery; Ligaments; Male; Orthopedics; Patient Satisfaction; Patients; Posterior Cruciate Ligament - injuries; Posterior Cruciate Ligament - surgery; Prospective Studies; Range of Motion, Articular; Reconstructive Surgical Procedures - methods; Tendons - transplantation; Transplantation, Autologous; Treatment Outcome
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-002-0288-9

We reviewed 18 patients (knees) operated on because of chronic PCL insufficiency. Preoperatively all the patients were severely disabled and showed a posterior drawer of 10 mm or more. A quadriceps tendon autograft was implanted using an open technique, direct posterior approach, and fixation to the tibia. A free semitendinosus graft was used to reconstruct the lateral collateral ligament in six knees and the medial collateral ligament in two. The patients were reviewed with a mean follow-up of 3.5 years (range 2-5.5) using the IKDC form. Stability was evaluated by stress radiography using the Telos device. The mean side-to-side difference in posterior tibial displacement at 70 degrees of knee flexion at follow-up was 4.8 mm; the side-to-side difference was less than 5 mm in 77% of cases. A side-to-side difference less than 2 mm in lateral joint line opening was found in five of six knees with a lateral collateral ligament reconstruction. Posterior tibial translation was similar in the knees with and those without collateral ligament reconstruction. Only one patient complained of significant pain and giving-way at follow-up. Patellofemoral crepitation was present in nine knees at follow-up although it was symptomatic only in one. The results of this series suggest that posterior cruciate ligament reconstruction using an autologous quadriceps tendon is a valuable option to reconstruct these severe injuries.