title: Reconstruction for chronic grade-II posterior cruciate ligament deficiency in Malaysian military personnel.
abstract: OBJECTIVE
  To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel.
  
  
  METHODS
  Medical records of 16 male military personnel aged 25 to 41 years who underwent reconstruction for chronic grade-II PCL deficiency using the quadruple hamstrings tendon by a single surgeon were reviewed. The mean time from injury to surgery was 43.6 (range, 3-104) months. 10 patients had grade-I (n=4), grade-III (n=2), and grade-IV (n=4) lesions of the medial femoral condyles. Seven patients had medial (n=6) and lateral (n=1) meniscus tears. At the 2-year follow-up, patients were asked to complete a questionnaire consisting of the Lysholm score, Tegner activity level, and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form. Posterior drawer test, KT-2000 arthrometer test for posterior translation of the tibia, and military health grade (MHG) were assessed by an independent assessor.
  
  
  RESULTS
  At the 2-year follow-up, the mean Lysholm score was 83; the score was excellent in 2 patients, good in 9, fair in 4, and poor in one. The mean IKDC subjective score was 74. The median Tegner activity level increased from 5.5 to 6. The posterior drawer test of 11 patients improved to grade I and the remaining 5 remained at grade II. The mean posterior translation of the tibia was 2.4 mm postoperatively; the posterior translation was normal in 8 patients, nearly normal in 7, and abnormal (≥ 6 mm) in one. The MHG improved in 14 patients and remained unchanged in 2. The latter 2 patients had no chondral lesion or meniscus injury. The first one was 40 years old with a postoperative IKDC score of 55 and a Tegner activity level of 2. The second one was 34 years old with a postoperative IKDC score of 65 and posterior translation of the tibia of 6 mm.
  
  
  CONCLUSIONS
  Surgical reconstruction for chronic grade-II PCL injury achieved satisfactory outcome and may be appropriate for military personnel.
authors.affiliation: Department of Orthopaedic and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Shahrulazua
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Department of Orthopedic, Tuanku Mizan Malaysian Armed Forces Hospital, Wangsa Maju, Kuala Lumpur, Malaysia.
authors.forename: Rafedon
authors.initials: R
authors.lastname: Mahidon
authors.affiliation: Department of Orthopaedic and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Shukur
authors.affiliation: Department of Orthopedic, Tuanku Mizan Malaysian Armed Forces Hospital, Wangsa Maju, Kuala Lumpur, Malaysia.
authors.forename: Amiruddin
authors.initials: A
authors.lastname: Hamdan
authors.affiliation: Department of Orthopedic, Tuanku Mizan Malaysian Armed Forces Hospital, Wangsa Maju, Kuala Lumpur, Malaysia.
authors.forename: Musa
authors.initials: M
authors.lastname: Kasmin
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008296:Malaysia; D008297:Male; D008889:Military Personnel; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous
keywords: military personnel; posterior cruciate ligament; treatment outcome