A Biomechanical Comparison of Posterior Cruciate Ligament Reconstructions Using Single- and Double-Bundle Tibial Inlay Techniques

Lutheran Medical Center, Brooklyn, New York, United States
The American Journal of Sports Medicine (Impact Factor: 4.36). 08/2005; 33(7):976-81. DOI: 10.1177/0363546504273046
Source: PubMed


The efficacy of using a double-bundle versus single-bundle graft for posterior cruciate ligament reconstruction has not been demonstrated.
A double-bundle graft restores knee kinematics better than a single-bundle graft does in tibial inlay PCL reconstructions.
Controlled laboratory study.
Eight cadaveric knees were subjected to 6 cycles from a 40-N anterior reference point to a 100-N posterior translational force at 10 degrees , 30 degrees , 60 degrees , and 90 degrees of flexion. Testing was performed for the intact and posterior cruciate deficient knee as well as for both reconstructed conditions. Achilles tendons, divided into 2 equal sections, were prepared as both single-bundle and double-bundle grafts. Both grafts were employed in the same knee, and the order of graft reconstruction was randomized.
There were no statistical differences in translation between the intact state and either of the reconstructions (P > .05) or between either of the reconstructions at any flexion angle (P > .05).
No differences in translation between the 2 graft options were identified.
The use of a double-bundle graft may not offer any advantages over a single-bundle graft for tibial inlay posterior cruciate reconstructions.

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    • "Harner et al.8) also reported that double bundle reconstruction resulted in better restoration of posterior stability, compared with single bundle reconstruction in cadaveric knees. However, in some studies,4-6,23,24) in terms of posterior stability, few differences were observed between single and double bundle PCL reconstruction, even though some different results were reported with different experimental settings. "
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    • "In a prospective, nonrandomized comparison of single bundle and double bundle transtibial reconstructions, Wang et al.29) did not detect any significant difference between the two techniques at a minimum of two years postoperatively. For a tibial inlay reconstruction, Bergfeld et al.30) compared single and double-bundle reconstructions using the tibial inlay technique of the posterior cruciate ligament based on cadaveric studies. They reported no differences in posterior tibial translation and concluded that it unnecessary to perform a double-bundle reconstruction of the posterior cruciate ligament if a tibial inlay construct is used. "
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