Clinical Outcome of Anatomical Arthroscopic Posterior Cruciate Ligament Reconstruction with Achilles Tendon Allograft

Document Type : RESEARCH PAPER

Authors

Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Regarding this, the present study aimed to assess the clinical outcome of anatomical arthroscopic
posterior cruciate ligament (PCL) reconstruction using Achilles tendon allograft.
Methods: This cross-sectional retrospective study was conducted on 24 patients undergoing anatomical arthroscopic
PCL reconstruction using Achilles tendon allograft during 2008-2014. The patients were examined in terms of knee
stability by clinical examinations and KT-2000 arthrometer, as well as regarding health and knee status, over a mean
follow-up of 36 months. In addition, the 36-Item Short-Form Health Survey (SF-36), International Knee Documentation
Committee Subjective Knee Form (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and Lysholm
were adopted to collect data.
Results: The participants had a mean age of 30±8 years and a mean body mass index of 25±2 kg/m2. Based on the
results of the SSD-KT2000 arthrometer, 12.5%, 34.37%, 28.12%, and 25% of the patients had normal, nearly normal,
abnormal, and severely abnormal laxity, respectively. In addition, the mean KOOS, Lysholm, IKDC, and Kujala scores
were estimated at 73.92±15, 79.50±17, 58.20±10.47, and 80.06±16, respectively. The patients with concomitant partial
meniscectomy had a significantly lower IKDC score (p <0.01).
Conclusion: Based on the findings, the use of Achilles tendon allograft in the surgical reconstruction of PCL would yield
excellent results both subjectively and objectively. In addition, patient selection and surgeon’s choice and preference
should be considered in determining the treatment plan for the patients.
Level of evidence: III

Keywords

References

1. Simon TD, Bublitz C, Hambidge SJ. Emergency
department visits among pediatric patients for
sports-related injury: basic epidemiology and impact
of race/ethnicity and insurance status. Pediatric
emergency care. 2006;22(5):309-15.
2. Yang J, Marshall SW, Bowling JM, Runyan CW, Mueller
FO, Lewis MA. Use of discretionary protective
equipment and rate of lower extremity injury in high
school athletes. American journal of epidemiology.
2005;161(6):511-9.
3. Kujala UM, Taimela S, Antti-Poika I, Orava S, Tuominen 
R, Myllynen P. Acute injuries in soccer, ice hockey,
volleyball, basketball, judo, and karate: analysis of
national registry data. BMJ : British Medical Journal.
1995;311(7018):1465-8.
4. Fox RJ, Harner CD, Sakane M, Carlin GJ, Woo SL.
Determination of the in situ forces in the human
posterior cruciate ligament using robotic technology.
A cadaveric study. Am J Sports Med. 1998;26(3):395-
401.
5. Miyasaka K, Daniel D, Stone M. The incidence of knee
ligament injuries in the general population. Am J Knee 
Surg 1991.
6. MacGillivray JD, Stein BE, Park M, Allen AA, Wickiewicz
TL, Warren RF. Comparison of tibial inlay versus
transtibial techniques for isolated posterior cruciate
ligament reconstruction: minimum 2-year follow-up.
Arthroscopy : the journal of arthroscopic & related
surgery : official publication of the Arthroscopy
Association of North America and the International
Arthroscopy Association. 2006;22(3):320-8.
7. Voos JE, Mauro CS, Wente T, Warren RF, Wickiewicz TL.
Posterior cruciate ligament: anatomy, biomechanics,
and outcomes. The American journal of sports
medicine. 2012;40(1):222-31.
8. Forsythe B, Haro MS, Bogunovic L, Collins MJ, Arns
TA, Trella KJ, et al. Biomechanical evaluation of
posterior cruciate ligament reconstruction with
quadriceps versus achilles tendon bone block
allograft. Orthopaedic journal of sports medicine.
2016;4(8):2325967116660068.
9. Wang CJ, Chen HS, Huang TW. Outcome of arthroscopic
single bundle reconstruction for complete posterior
cruciate ligament tear. Injury. 2003;34(10):747-51.
10. Deie M, Adachi N, Nakamae A, Takazawa K, Ochi M.
Evaluation of Single-Bundle versus Double-Bundle
PCL Reconstructions with More Than 10-Year Follow-
Up2015. 1-5 p.
11. Sekiya JK, West RV, Ong BC, Irrgang JJ, Fu FH, Harner CD.
Clinical outcomes after isolated arthroscopic singlebundle
posterior cruciate ligament reconstruction.
Arthroscopy : the journal of arthroscopic & related
surgery : official publication of the Arthroscopy
Association of North America and the International
Arthroscopy Association. 2005;21(9):1042-50.
12. Hermans S, Corten K, Bellemans J. Long-term results
of isolated anterolateral bundle reconstructions of the
posterior cruciate ligament: a 6- to 12-year follow-up
study. Am J Sports Med. 2009;37(8):1499-507.
13. Yang JH, Yoon JR, Jeong HI, Hwang DH, Woo SJ, Kwon
JH, et al. Second-look arthroscopic assessment
of arthroscopic single-bundle posterior cruciate
ligament reconstruction: comparison of mixed graft
versus achilles tendon allograft. Am J Sports Med.
2012;40(9):2052-60.
14. Boutefnouchet T, Bentayeb M, Qadri Q, Ali S. Longterm
outcomes following single-bundle transtibial
arthroscopic posterior cruciate ligament reconstruction.
International Orthopaedics. 2013;37(2):
337-43.
15. Kwon JH, Han JH, Jo DY, Park HJ, Lee SY, Bhandare
N, et al. Tunnel volume enlargement after posterior
cruciate ligament reconstruction: comparison of
achilles allograft with mixed autograft/allograft-
-a prospective computed tomography study.
Arthroscopy : the journal of arthroscopic & related
surgery : official publication of the Arthroscopy
Association of North America and the International
Arthroscopy Association. 2014;30(3):326-34.
16. Wang CJ, Chan YS, Weng LH, Yuan LJ, Chen HS.
Comparison of autogenous and allogenous posterior
cruciate ligament reconstructions of the knee. Injury.
2004;35(12):1279-85.
17. Heinzelmann AD, Barrett GR. Posterior cruciate
ligament reconstruction: Achilles tendon allograft,
double bundle. Clinics in sports medicine.
2009;28(2):245-57, viii.
18. Motamed N AA, Zare N, Sadeghi Hassanabadi A.
Validity and reliability of the Persian translation of
the SF-36 version 2 questionnaire. EMHJ-Eastern
Mediterranean Health Journal. 2005:349-57.
19. McGuire DA, Hendricks SD. Comparison of anatomic
versus nonanatomic placement of femoral tunnels
in Achilles double-bundle posterior cruciate
ligament reconstruction. Arthroscopy: The Journal of
Arthroscopic & Related Surgery. 2010;26(5):658-66.
20. Kim S-J, Jung M, Moon H-K, Kim S-G, Chun Y-M.
Anterolateral transtibial posterior cruciate ligament
reconstruction combined with anatomical reconstruction
of posterolateral corner insufficiency:
comparison of single-bundle versus double-bundle
posterior cruciate ligament reconstruction over a
2-to 6-year follow-up. The American journal of sports
medicine. 2011;39(3):481-9.
21. Mariani PP, Adriani E, Santori N, Maresca G. Arthroscopic
posterior cruciate ligament reconstruction
with bone-tendon-bone patellar graft. Knee surgery,
sports traumatology, arthroscopy : official journal of
the ESSKA. 1997;5(4):239-44.
22. Shelbourne KD, Davis TJ, Patel DV. The natural history
of acute, isolated, nonoperatively treated posterior
cruciate ligament injuries. A prospective study. Am J
Sports Med. 1999;27(3):276-83.
23. Nyland J, Hester P, Caborn DN. Double-bundle posterior
cruciate ligament reconstruction with allograft tissue:
2-year postoperative outcomes. Knee Surgery, Sports
Traumatology, Arthroscopy. 2002;10(5).
24. T. Janousek A, Jones D, Clatworthy M, D. Higgins L, H.
Fu F. Posterior Cruciate Ligament Injuries of the Knee
Joint2000. 429-41 p.
25. Cross MJ, Powell JF. Long-term followup of posterior
cruciate ligament rupture: a study of 116 cases. Am J
Sports Med. 1984;12(4):292-7.
26. Chen CH, Chen WJ, Shih CH. Arthroscopic
reconstruction of the posterior cruciate ligament:
a comparison of quadriceps tendon autograft and
quadruple hamstring tendon graft. Arthroscopy:
the journal of arthroscopic & related surgery :
official publication of the Arthroscopy Association
of North America and the International Arthroscopy
Association. 2002;18(6):603-12.
27. Mygind-Klavsen B, Nielsen TG, Lind MC. Outcomes After
Posterior Cruciate Ligament (PCL) Reconstruction
in Patients With Isolated and Combined PCL Tears.
Orthopaedic Journal of Sports Medicine. 2017;
5(4):2325967117700077.
The Archives of Bone and Joint Surgery
Volume 9, Issue 1
January 2021
Pages 79-84

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History

  • Receive Date: 06 September 2020
  • Revise Date: 23 December 2020
  • Accept Date: 27 December 2020

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