Postoperative Evaluation of Knees with Posterior Cruciate Ligament Injury using Patient-Oriented Evaluation Method: Comparison of Single-Bundle and Anatomic Double-Bundle Techniques

Author(s): Satoshi Ochiai, Tetsuo Hagino, Shinya Senga, Naoto Furuya, Naofumi Taniguchi, Takashi Ando, Hirotaka Haro

Background: Some reports showed, no clear difference in treatment outcome between the single-bundle and double-bundle reconstruction techniques for posterior cruciate ligament (PCL) injury. Using the patientbased QOL evaluation scale SF-36, we evaluated the postoperative outcome and compared the two reconstruction techniques.

Methods: 37 male patients with isolated PCL injury who underwent reconstruction were randomized to receive single-bundle reconstruction (group S: n=20) or double-bundle reconstruction (group D: n=17). Before surgery and 6 and 24 months after surgery, patients were evaluated by SF-36 scores, Lysholm score, VAS, posterior tibial displacement rate, and ROM.

Results: For SF-36 evaluation at 6 months post-surgery, the scores of all the subscales improved to above the national standard values in group D, whereas none of the subscale scores reached the national standard values in group S, and three subscale scores were inferior in group S compared to group D. At 24 months post-surgery, improvement of all subscale scores to above the national standard values was achieved in both groups. Lysholm score, VAS score, and posterior tibial displacement rate improved after surgery in both groups, but no significant intergroup differences were observed in all evaluation methods. For knee ROM, residual limitation of flexion was significantly more frequent in group S than in group D at 6 and 24 months post-surgery.

Conclusion: Arthroscopy-assisted single-bundle PCL reconstruction technique is considered to be a safe procedure with low invasiveness, but despite its widespread use, surgical result is not consistently good. According to the present results, double-bundle reconstruction tended to achieve better restoration at an early stage compared to single-bu