Clinical research for reason analysis of posterior cruciate ligament reconstruction revision / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To study and analyze the clinical factors contributing to the failure of primary posterior cruciate ligament (PCL) reconstruction and to guide our clinical treatment.</p><p><b>METHODS</b>From November 2001 to May 2007, 8 patients underwent PCL reconstruction revision because of pathological instability after primary PCL reconstruction. And the clinical failure factors of the primary reconstruction were analyzed.</p><p><b>RESULTS</b>One case was reconstructed with bone-patellar tendon-bone (B-T-B) autografts, 7 cases with hamstring tendon autograft. The most probable causes of failure were improper graft placement in 7 cases (both femoral bone tunnels were behind the predicted one and tibial tunnels were in front of the predicted one). The reconstructed PCL in 4 cases ruptured absolutely and had been absorbed. Three cases had obviously loosen but still partly linked reconstructed ligament. These 8 cases all received primary PCL revision reconstruction. Among them, 6 cases were reconstructed with autograft (using a single-bundle quadruple hamstring graft in 3 cases, double-bundle quadruple hamstring graft in 1 case, single-bundle B-T-B autograft in 2 case), and 2 cases were reconstructed with allograft (using a single-bundle and a double-bundle B-T-B allograft reconstruction).</p><p><b>CONCLUSIONS</b>Incorrect bone tunnel placement is the major factor contributing to the surgical failure in many reasons for the failure of PCL reconstruction. So, it might be suggested that there is a great need for a more precise anatomical bone tunnel placement.</p>