A Study on the Results of Reconstructing Posterior Cruciate Ligament Using Graft from Quadriceps Muscle Tendon

Abstract

Background: Many of the knees affected by rupture of the posterior cruciate ligament (PCL) lack their desirable function. Researchers are currently seeking surgical procedures for treating PCL rupture, which can offer a reliable degree of objective and subjective knee stability after surgery. This study assesses the results of anatomical reconstruction of PCL using graft from the tendon of the quadriceps muscle. Methods: This is a descriptive prospective study involving 14 patients with clinical diagnosis of PCL rupture. The patients complained of knee discomfort in spite of conservative treatment and many sessions of physiotherapy. Subjective symptoms of knee instability, i.e. giving way, pain after long walks and pain during climbing, as well as objective knee instability symptoms as assessed by posterior drawer test at 30° and 90° knee flexion, and neutral rotation were recorded and compared prior to and after surgery. The procedure entailed anatomical reconstruction of PCL using grafts taken from the tendon of quadriceps muscle and part of proximal patella. Results: Two patients were excluded from the study due to their failure to refer for follow-up. The patients included 11 men and 1 woman with a mean age of 23 years. The patients displayed statistically significant improvement after surgery as regards subjective symptoms, i.e. giving way, pain after long walks and pain in climbing. Objective knee instability symptoms as evaluated by posterior drawer test at 30° and 90° knee flexion and neutral rotation also showed significant improvement compared to pre-operation findings. Conclusion: Reconstruction of PCL is aimed at achieving normal knee kinematics and stability. The procedure used in this study entailed anatomical reconstruction of PCL. Given the objective and subjective results obtained, the use of this procedure is recommended by authors as the method of choice for reconstructing PCL.
Keywords: Posterior Cruciate Ligament, Knee Instability, Quadriceps Tendon