Purpose: The purpose of this study was to evaluate the clinical outcomes after arthroscopic single-bundle posterior cruciate ligament (PCL) reconstruction in patients with isolated grade III PCL injuries.
Type of study: Retrospective review.
Methods: Twenty-one patients who underwent an isolated arthroscopic single-bundle PCL reconstruction for the treatment of a grade III PCL injury between 1989 and 1998 were included in the study. There were 15 male and 6 female patients with an average age of 38 years (range, 20 to 62 years). The length of follow-up was 5.9 years (range, 2.6 to 11 years), and the average time from injury to surgery was 4.5 years (median, 1.3 years; range, 2 weeks to 25 years). All patients completed a subjective evaluation and 14 patients returned for a physical examination and radiographs. One patient underwent an acute reconstruction (<3 weeks), 4 had a subacute (<3 months), and 16 underwent a chronic (>3 months) reconstruction. The anterolateral bundle of the PCL was reconstructed using an Achilles tendon allograft passed through femoral and tibial bone tunnels.
Results: The overall average Activities of Daily Living Scale (ADLS), Sports Activities Scale (SAS), and SF-36 scores were 79.3, 71.6, and 98 points, respectively. There was a significant difference identified when the ADLS (91.3 v 75.6) and the SAS (90.4 v 65.8) scores of the subacute/acute group were compared with those of the chronic reconstruction group. Using the International Knee Documentation Committee (IKDC) subjective assessment, 57% of the patients had normal/near normal knee function, and 62% had a normal/near normal activity level. The average extension and flexion losses were 1 degrees and 5 degrees , respectively. Instrumented laxity examination revealed that 62% had less than a 3-mm and 31% had a 3- to 5-mm side-to-side difference in corrected posterior displacement. Radiographs at follow-up showed that 75% had normal/near normal findings according to IKDC guidelines.
Conclusions: The clinical outcomes after arthroscopic single-bundle PCL reconstruction in this study produced a satisfactory return of function and improvement in symptoms. All patients in this study had improved laxity of at least 1 grade. When compared with chronic reconstructions, acute reconstructions had statistically significant better ADLS and SAS scores.
Level of evidence: IV, case series.