Incomplete bicruciate knee injuries: Results of treatment with isolated anterior cruciate ligament reconstruction.
OBJECTIVE
To determine how the presence of a partial injury to the posterior cruciate ligament (PCL) in conjunction with an anterior cruciate ligament (ACL) tear affects the outcome of ACL reconstruction.


METHODS
Case series.


METHODS
Between 1990 and 1998, 18 patients with surgically documented complete ACL ruptures and partial PCL tears, referred to as "incomplete bicruciate knee injuries," were treated with arthroscopic ACL reconstruction and PCL observation. Fifteen patients (83%) were available for follow-up evaluation at a mean of 60 months postoperatively. Follow-up evaluation consisted of physical examination, standard radiographs, isokinetic muscle testing, KT instrumented laxity testing, stress radiographs for posterior and total anterior-posterior translation, and Lysholm, Tegner, and IKDC outcome scores.


RESULTS
At follow-up, 11 patients had a negative Lachman and 4 had a 1+ Lachman (3 to 5 mm translation). Instrumented arthrometer tests performed at follow-up showed less than 3 mm of increased anterior translation versus the opposite knee on manual maximum testing at 30 degree in 11 patients, and 3 to 5 mm translation in the remaining 4 patients, with an average of 1.3 mm increased translation. Symptomatic posterior instability was present in only 1 patient who had sustained a repeat injury resulting in a complete PCL tear postoperatively. Final IKDC outcome scores were normal or near normal in 13 patients (87%) and abnormal in 2 (13%). The average Lysholm score was 93 at follow-up, and only 1 patient had a score lower than 80.


CONCLUSIONS
Overall, the results of treatment of incomplete bicruciate knee injuries in this study compare favorably with the results of isolated ACL reconstruction reported in other series. We conclude that the clinical significance of an arthroscopically defined partial PCL tear in an ACL-deficient knee is minor, and that isolated ACL reconstruction in this setting appears to be effective treatment.
Wolf
Robert S
RS
American Sports Medicine Institute, Birmingham, Alabama, USA.
Lemak
Lawrence J
LJ
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007718:Knee Injuries / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome