In vitro study of knee stability after two-band two-tunnel posterior cruciate ligament reconstruction.
OBJECTIVE
To compare the ability of three different reconstruction procedures in restoring the posterior displacement of tibia and the posterior stability of the knee joint from 0 degree to 120 degrees flexion.


METHODS
Three posterior cruciate ligaments (PCL) reconstruction procedures were performed, namely two-band two-tunnel reconstruction, one-band anterior tunnel reconstruction and one-band posterior tunnel reconstruction. The posterior displacement of the tibia in relation to the femur was measured when a 200N posterior force was applied.


RESULTS
Within the flexion range of 0 degree to 30 degrees, the displacement in the one-band posterior tunnel reconstruction showed little difference from that of an intact knee (P>0.05). But when the flexion exceeded 30 degrees, especially when it exceeded 60 degrees, the displacement in one-band posterior tunnel reconstruction was much greater than that of an intact knee (P<0.01). In two-band two-tunnel reconstruction and one-band anterior tunnel reconstruction, the displacement was approximately the same as that of an intact knee ranging from 0 degree to 120 degrees (P>0.05), while a slight over-restriction might be found at some angles.


CONCLUSIONS
Two-band reconstruction could effectively restrict the posterior displacement of the tibia and restore anterior, posterior stability of the knee joint within its full range of flexion. One-band anterior tunnel reconstruction also could maintain the posterior stability of the knee, while the result of one-band posterior tunnel reconstruction is the most unsatisfactory.
Mao
Yuan-qing
YQ
Department of Orthopedic Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, China. maoyuanqing@citiz.net
Chen
Bai-cheng
BC
Zhu
Zhen-an
ZA
D000328:Adult; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011184:Postoperative Period; D016059:Range of Motion, Articular