Arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique / 中华创伤骨科杂志

Objective To evaluate arthroscopic PCL (posterior cruciate ligament) reconstruction with an implant fixaliun of hamstring tendon knot and bottle-neck technique.Methods Thirteen cases with PCL injury were treated with arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique between April,2002 to June,2005.The patients were followed up fur at least seven months to evaluate the clinical effects by means of ROM of the joint,post drawer test,Lachman test,Lysholm and IKDC (International Knee Documents Committee) scores.Results The patients were followed up for an average of 13.4 months.No limitation of knee extension was found six months after operation.Eleven patients had normal knee flexion(＞140?), one had knee flexion of 120?and one 100?.In posterior drawer test,11 patients were gradeⅠand two gradeⅡ.In Lachman test,11 patients were rated as within gradeⅠand two gradeⅡ.By Lysholm knee function scale,the average knee scores were 90.47?4.13 and 78.82?2.46 respectively before and after operation,and the dif- ference was of statistical significance (t=2.416,P=0.029).By IKDC scale,six were grade A,five grade B and one grade C.Conclusion Arthroseopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique is a reliable method to restore knee function and will have a prospect of wide application be- cause of its good tissue biocompatibility,less invasion,and less operative expenditure.

A Biomechanical Study of Graft Fixation in Posterior Cruciate Ligament Reconstruction / 대한정형외과학회잡지

Injuries of the posterior cruciate ligament have almost universally been treated nonoperatively in the past due to indignity of this complex structure. Recent studies have shown new informations on the anantomical, histological, biomechanical characteristics of the Posterior cruciate ligament PCL), and thereby interest of reconstruction surgery is increasing. But intraarticular PCL reconstruction still remains one of the most challenging problems in knee surgery. Although, various types of graft and surgical techniques have been used for reconstruction, results of surgery has been variable. In this study, three different methods of graft fixation for PCL reconstruction are evaluated biomechanically to determine the effect on mechanical property of reconstructed PCL using 30 porcine knees. Grafts used in this study were bone-patellar tendon-bone fixed with interference screw and Achilles tendon tied with suture. Additionally, five original PCLs were also tested by Instron universal testing instrument to determine its mechanical proprety. Tensile test was performed at extended knee position. It was demonstrated that mechanical strength of bone-patellar tendon-bone graft is superior to that of Achilles tendon graft. All of the failures of bone-patellar tendon-bone graft and Achilles tendon graft occurred at tibial fixation site whereas original PCLs which failed at proximal midsubstance of ligament. In conclusion, tensile strength of Bone-patellar tendon-bone graft used for PCL reconstruction is higher than that of Achilles tendon but latter can be used in terms of as clinical meanings.