Objective
To evaluate the biomechanical effect of graft thickness compared with the double-bundle technique on posterior cruciate ligament (PCL) reconstruction in human cadaveric knees.
Methods
A total of 9 human cadaveric knees were tested in 5 conditions: intact knee (INT); single-bundle reconstruction with a 10-mm quadriceps tendon (SB); double-bundle reconstruction with a 10 mm-quadriceps tendon for the anterolateral bundle and a 7-mm doubled semitendinosus tendon for the posteromedial bundle (DB); single-bundle reconstruction with a 10-mm quadriceps tendon plus a 7-mm doubled semitendinosus tendon (SBT); and PCL-deficient (NoPCL). The posterior tibial translation (PTT) was measured in response to a 134-N posterior tibial load at 0
∘
, 30
∘
, 60
∘
e 90
∘
of knee flexion.
Results
The PTT values of the DB and SBT techniques were always significantly lower (better stability) than those of the SB technique. The PTT values of the SBT technique were significantly lower than those of the DB technique at 60
∘
(
p
= 0.005) and 90
∘
(
p
= 0.001).
Conclusions
Graft enlargement improves knee stability in isolated PCL reconstructions, whereas the graft division in the two-bundle technique worsens this stability at 60
∘
and 90
∘
of knee flexion. The findings of the present study suggest that knee stability in PCL reconstructions may be improved with the use of thicker grafts in the SB technique rather than performing the DB technique.
Proximal and distal realignments produce better results than isolated proximal realignment in patients with joint degeneration or with greater duration of disease. The realignment surgery does not produce good results in patients with advanced disease.
Trabalho de revisão bibliográfica referente à isometricidade do ligamento cruzado posterior. São avaliados doze artigos que estudam a isometricidade do ligamento, constatando que a maioria destes é concorde com a maior importância da inserção femoral na isometricidade e que existe uma linha ou área mais isométrica na inserção femoral, aproximadamente perpendicular ao teto da fossa intercondilar, localizada de 10 a 14mm da abertura anterior desta fossa.
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