title: Arthroscopic reconstruction of the posterior cruciate ligament with use of a quadruple hamstring tendon graft with 3- to 5-year follow-up.
abstract: OBJECTIVE
  This study prospectively evaluated 20 patients treated consecutively to determine patient outcomes, efficacy, and complication potential of arthroscopically assisted posterior cruciate ligament (PCL) reconstruction performed with hamstring tendon grafts.
  
  
  METHODS
  Twenty patients (15 men and 5 women), each with an isolated PCL injury, underwent PCL reconstruction with hamstring tendon autograft and were enrolled in this prospective study. Average age at time of surgery was 29 years (range, 20 to 57 years). Average time from injury to surgery was 4 months (range, 3 to 12 months). Average follow-up period was 40 months (range, 36 to 50 months). Patients underwent regular follow-up after clinical and radiographic preoperative and postoperative evaluation. Follow-up examinations comprised the Lysholm Knee Score, the Tegner Activity Score, the International Knee Documentation Committee (IKDC) score, thigh muscle assessment, and radiographic evaluation.
  
  
  RESULTS
  Mean preoperative Lysholm score for 20 knees was 63 +/- 10 (range, 48-73); mean postoperative Lysholm score was 93 +/- 9 (range, 77-100). Eighteen of 20 patients (90%) showed good or excellent results at final assessment. Mean preinjury and preoperative Tegner scores were 7 +/- 1.5 (range, 5-9) and 3 +/- 1.9 (range, 2-5), respectively; mean postoperative Tegner score for 20 knees was 6.3 +/- 2.4 (range, 4-9). In final IKDC ratings, 85% of patients (17 of 20) were assessed as normal or near normal (grade A or B). A statistically significant improvement was seen in thigh girth difference, extensor strength ratio, and flexor strength ratio before and after reconstruction at a minimum of 3 years of follow-up.
  
  
  CONCLUSIONS
  After follow-up for longer than 36 months, analytical results showed satisfactory function after PCL reconstruction with the use of hamstring tendon autografts. We suggest that the hamstring tendon autograft is a safe, effective, and acceptable choice for PCL reconstruction, and that it affords good ligament reconstruction.
  
  
  METHODS
  IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Division of Sports Medicine, Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan. chan512@adm.cgmh.org.tw
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Chan
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Yang
authors.forename: Chung-Hsun
authors.initials: CH
authors.lastname: Chang
authors.forename: Alvin Chao-Yu
authors.initials: AC
authors.lastname: Chen
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Yuan
authors.forename: Kuo-Yao
authors.initials: KY
authors.lastname: Hsu
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology; D009133:Muscular Atrophy / Q000473:pathology; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D020127:Recovery of Function; D013710:Tendons / Q000637:transplantation*; D013848:Thigh; D014182:Transplantation, Autologous; D015599:Trauma Severity Indices; D016896:Treatment Outcome