Outcome of Simultaneous Arthroscopic Anterior Cruciate Ligament and Posterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: A Multicenter Prospective Study

Abstract

Background:Multiligamentous injuries of knee are a complex problem in orthopaedics. Combined ACL-PCL injuries are uncommon, usually associated with knee dislocations. Extremity vascular status is essential because of possible arterio-venous compromise. These complex injuries require a systematic evaluation and treatment. Single setting simultaneous arthroscopic ACL and PCL reconstruction or a staged approach can be adopted to treat these cases.Objectives:To evaluate functional outcome of simultaneous arthroscopic ACL and PCL reconstruction with hamstring tendon autograft in multiligamentous knee injuries.Patients and Methods:This prospective study was performed on 20 patients with combined ACL-PCL injuries who underwent simultaneous arthroscopic ACL-PCL reconstruction with hamstring tendon. Evaluation of functional outcome was by IKDC and Lysholm-Tegner scores.Results:In 20 patients, mean age 34 years, return to full-time work and to full sports was 8 weeks and 6.2 months respectively. All patients had full range of motion except 2 patients with < 5 degrees flexion loss; 90% had negative Lachmann test; 95% had negative pivot shift and 10% patients had mild posterior drawer at 90 degrees (1+) at final follow up. Mean IKDC score was 90 (range 81 - 94); mean Tegner activity score was 7 and mean Lysholm knee score was 89. 85% returned to preinjury activity level and a 90% satisfaction rate.Conclusions:Simultaneous arthroscopic ACL and PCL reconstructions using hamstring tendon for combined ACL and PCL injuries is a clinically effective, safe, time saving and cost-effective procedure with better patient compliance and reproducible for a timely return of motion, strength, and function with favorable outcome.

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

“…One of the important controversies in PCL reconstruction is graft tissue selection between autograft tendons and allograft tendons. [ 6 – 8 ] Autogeneic and allogeneic graft tissues have unique advantages and disadvantages. [ 9 ] Li et al [ 10 ] demonstrated that the outcomes were similar between hamstring tendon autografts and tibialis anterior allografts in single-bundle PCL reconstruction.…”

Similar functional outcomes of arthroscopic reconstruction in patients with isolated Posterior Cruciate Ligament (PCL) and combined Anterior Cruciate Ligament (ACL) and PCL tears

“…In a multicentre prospective study by Panigrahi et al on 20 patients of combined ACL and PCL reconstructions, satisfactory improvement in Lysholm score, IKDC scores and Tegner activity scores comprehending the results of the present study. 33 However, this study had several limitations. Firstly, this study was a case series compared to the present study where comparison was made between 2 groups (isolated PCL and combined ACL and PCL reconstructions); Secondly, presence of PLC/MCL/LCL injuries along with combined ACL and PCL injuries may have added selection bias; Thirdly, this study had a short follow-up of 26 months compared to the current study with minimum follow-up of five years.…”

Arthroscopic Reconstruction of the Posterior Cruciate Ligament With Ligament Advanced Reinforcement System and Hamstring Tendon Autograft :A Retrospective Study

“…One dispute concerns the selection of grafts. Hamstring tendon represents the most common graft used for PCL reconstruction (3,4) since it is easily available and rejection-free, involves no risk of infection and can achieve quick tendon-bone healing. LARS mimics natural ligament in terms of biological properties (11).…”