Posterior cruciate ligament reconstruction: double-loop hamstring tendon autograft versus Achilles tendon allograft--clinical results of a minimum 2-year follow-up

Arthroscopy. 2005 Aug;21(8):965-9. doi: 10.1016/j.arthro.2005.05.004.

Abstract

Purpose: The purpose of this study was to compare clinical results of arthroscopic posterior cruciate ligament (PCL) reconstructions using double-loop hamstring tendon autograft and Achilles tendon allograft while preserving the original PCL remnant.

Type of study: Case-control study of results of treatment.

Methods: From September 1997 to December 2000, 36 patients who received only PCL reconstruction were reviewed retrospectively. Of these, 18 patients received autogenous double-loop hamstring tendon reconstruction (group I) and 18 received Achilles tendon allograft reconstruction (group II). The same PCL reconstruction procedure was performed in both groups. At final follow-up at a minimum of 2 years, patients were evaluated by 4 measures: the International Knee Documentation Committee (IKDC) evaluation, Lysholm knee scores, the posterior draw test, and Telos stress radiography.

Results: Between the 2 groups, preoperative demographic factors (age, gender, activity level, and mean duration to surgery) showed no statistically significant difference (P > .05). According to IKDC evaluation of group I, 16 of the 18 knees rated normal or nearly normal, whereas 2 fell into the abnormal category. By the same criteria, 14 of the 18 knees in group II were normal to nearly normal, 3 were abnormal, and 1 was severely abnormal. IKDC scores showed no statistical difference between the 2 groups (P = .98). Postoperative mean Lysholm knee scores were 90 points (range, 78-100) for group I and 85 (range, 70-95) for group II; improvements of 22 and 17 points, respectively. According to the Lysholm knee scores, group I showed slightly better results than did group II, with a statistical significance of P < .01. Telos stress radiography showed the mean difference in posterior translation between the injured and uninjured knees to be 2.2 mm (range, 0 to 7.0 mm) for group I and 2.9 mm (range, 1.0 to 7.0 mm) for group II. The Telos stress test showed no statistical difference between the 2 groups (P = .14).

Conclusions: The clinical outcome was the same for both groups. Despite its comparatively short length and small diameter, the double-loop hamstring tendon autograft was as good as Achilles tendon allograft in PCL reconstruction.

Level of evidence: Level III, case-control study.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Absorbable Implants
  • Achilles Tendon / transplantation*
  • Adolescent
  • Adult
  • Arthroscopy / methods*
  • Bone Screws
  • Female
  • Femur / surgery
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Posterior Cruciate Ligament / injuries
  • Posterior Cruciate Ligament / surgery*
  • Retrospective Studies
  • Second-Look Surgery
  • Severity of Illness Index
  • Stress, Mechanical
  • Tendons / transplantation*
  • Tibia / surgery
  • Transplantation, Homologous
  • Treatment Outcome