Posterior cruciate ligament reconstruction: current trends.
A survey was conducted of the Herodicus Society membership to assess the current status of treating posterior cruciate ligament (PCL) injuries and compared to a similar survey conducted in 1991. The survey addressed indications, graft choice, surgical technique, graft tensioning, and graft fixation. Seventy-eight active surgeons were sent a 34-question survey pertaining to isolated PCL injuries. The majority of respondents (78%) performed < or = 10 PCL reconstructions per year. The arthroscopic assisted with posteromedial portal technique was the most commonly used (49%). The tibial inlay/onlay technique was used by 15%, and 68% used the single femoral tunnel technique. The remainder used a double femoral tunnel technique. Allograft Achilles tendon was the most commonly selected graft for acute (43%) and chronic (50%) PCL reconstructions. An interference screw for femoral fixation was used 67% of the time. The majority of respondents (55%) tensioned their single bundle or anterolateral band of a double bundle in 71 degrees-90 degrees of flexion. A significant difference in technique was noted when comparing those who performed < or = 10 PCL reconstructions per year (group 1) versus > 10 PCL reconstructions per year (group 2). In group 1, 25% of surgeons used a double tunnel technique versus 59% of surgeons in group 2. The most common operative treatment for PCL injuries consisted of a single femoral tunnel with an Achilles tendon allograft. When compared to a similar survey conducted in 1991, the notable differences were a trend toward Achilles tendon allograft and the popularization of the double femoral tunnel and tibial inlay/onlay technique.
Dennis
Michael G
MG
Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill, USA.
Fox
Jeff A
JA
Alford
J Winslow
JW
Hayden
Jennifer K
JK
Bach
Bernard R
BR
D000125:Achilles Tendon / Q000637:transplantation; D001291:Attitude of Health Personnel; D001863:Bone Screws / Q000706:statistics & numerical data; D005269:Femur / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D019637:Orthopedic Procedures / Q000379:methods*; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012955:Societies, Medical; D013178:Sports Medicine; D011795:Surveys and Questionnaires; D013977:Tibia / Q000601:surgery; D014481:United States