Reconstructions of the Knee Following Combined Injury to the Posterior Cruciate Ligament and the Posterior Lateral Structures Michael

摘要

The posterior cruciate ligament (PCL) provides primary restraint to posterior tibial translation (1). Knee injuries involving only the PCL usually result in minimal disability, and are commonly treated non-surgically (2). However, combined injuries of the PCL and the posterior lateral structures (PLS) in the knee can result in considerable abnormal posterior laxity and posterolateral rotary instability leading to rapid cartilage degeneration (3). There is consensus that, in most cases, knees with this combined injury require surgical reconstruction. The PCL is composed of two major bands or bundles (4): the large, anterolateral bundle (ALB), which tightens with knee flexion, and the smaller, posteromedial bundle (PMB), which tightens with knee extension. Because of the existence of these two bundles and their separate functions, there remains uncertainty as to whether a single stranded PCL graft is sufficient or a double stranded graft is required to adequately reconstruct a knee with a combined PCL/PLS injury. The purpose of this study was to compare, in an invitro experiment, the restoration of normal joint positioning and kinematics by single and double strand PCL reconstructions in a knee with a combined PCL/PLS injury.