Clinical outcomes after isolated arthroscopic single-bundle posterior cruciate ligament reconstruction.
OBJECTIVE
The purpose of this study was to evaluate the clinical outcomes after arthroscopic single-bundle posterior cruciate ligament (PCL) reconstruction in patients with isolated grade III PCL injuries.


METHODS
Retrospective review.


METHODS
Twenty-one patients who underwent an isolated arthroscopic single-bundle PCL reconstruction for the treatment of a grade III PCL injury between 1989 and 1998 were included in the study. There were 15 male and 6 female patients with an average age of 38 years (range, 20 to 62 years). The length of follow-up was 5.9 years (range, 2.6 to 11 years), and the average time from injury to surgery was 4.5 years (median, 1.3 years; range, 2 weeks to 25 years). All patients completed a subjective evaluation and 14 patients returned for a physical examination and radiographs. One patient underwent an acute reconstruction (<3 weeks), 4 had a subacute (<3 months), and 16 underwent a chronic (>3 months) reconstruction. The anterolateral bundle of the PCL was reconstructed using an Achilles tendon allograft passed through femoral and tibial bone tunnels.


RESULTS
The overall average Activities of Daily Living Scale (ADLS), Sports Activities Scale (SAS), and SF-36 scores were 79.3, 71.6, and 98 points, respectively. There was a significant difference identified when the ADLS (91.3 v 75.6) and the SAS (90.4 v 65.8) scores of the subacute/acute group were compared with those of the chronic reconstruction group. Using the International Knee Documentation Committee (IKDC) subjective assessment, 57% of the patients had normal/near normal knee function, and 62% had a normal/near normal activity level. The average extension and flexion losses were 1 degrees and 5 degrees , respectively. Instrumented laxity examination revealed that 62% had less than a 3-mm and 31% had a 3- to 5-mm side-to-side difference in corrected posterior displacement. Radiographs at follow-up showed that 75% had normal/near normal findings according to IKDC guidelines.


CONCLUSIONS
The clinical outcomes after arthroscopic single-bundle PCL reconstruction in this study produced a satisfactory return of function and improvement in symptoms. All patients in this study had improved laxity of at least 1 grade. When compared with chronic reconstructions, acute reconstructions had statistically significant better ADLS and SAS scores.


METHODS
IV, case series.
Sekiya
Jon K
JK
Bone and Joint/Sports Medicine Institute, Uniformed Health Services University of the Health Sciences, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
West
Robin V
RV
Ong
Bernard C
BC
Irrgang
James J
JJ
Fu
Freddie H
FH
Harner
Christopher D
CD
D000125:Achilles Tendon / Q000637:transplantation; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013977:Tibia / Q000601:surgery; D014182:Transplantation, Autologous; D016042:Transplantation, Heterotopic; D016896:Treatment Outcome