title: Posterior cruciate ligament reconstruction by transfer of the medial gastrocnemius tendon.
abstract: A retrospective study to determine the efficacy of medial gastrocnemius tendon transfer for symptomatic PCL instability is presented. Results from a group of 31 patients undergoing this procedure were compared with a group of 8 patients managed conservatively while awaiting surgery. The mean injury to follow-up interval was 82 months in the operated group and 104 months in the nonoperated group. The mean surgery to follow-up interval was 53 months. Sixty-nine percent of surgical patients were subjectively improved; however, 29 (91%) continued to have pain and 19 (59%) continued to experience giving way. Thirteen patients from the operated group who had associated procedures performed were significantly better subjectively than those with no associated procedures (P less than 0.05). Physical examination demonstrated no difference in clinical laxity between the operated and nonoperated groups. Medial gastrocnemius transfer did not result in any significant reduction in anterior-posterior translation (KT-1000 assessment) when reconstructed knees were compared with control posterior cruciate deficient knees. Surgery, combined with subsequent immobilization, may have also been responsible for the significant reduction in lower limb function observed in the reconstructed patients. We do not recommend this procedure as a primary PCL reconstruction.
authors.affiliation: Division of Orthopaedic Surgery, Victoria Hospital, University of Western Ontario, London, Canada.
authors.forename: J H
authors.initials: JH
authors.lastname: Roth
authors.forename: R C
authors.initials: RC
authors.lastname: Bray
authors.forename: T M
authors.initials: TM
authors.lastname: Best
authors.forename: L A
authors.initials: LA
authors.lastname: Cunning
authors.forename: R P
authors.initials: RP
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010808:Physical Examination; D012086:Reoperation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013537:Sutures; D013709:Tendon Transfer