The Reconstruction Of Posterior Cruciate Ligament Using Semitendinosus Tendon

Object Posterior cruciate ligament injury of knee joint is a clinical common disease. So far there still exist some controversies about its treatments. With the research of the structure, function and biological characteristic of the knee joint and the investigation of natural recovery and the secondary effect after damage of knee joint, the surgical reconstructions have been doing by more and more scholar. As the posterior cruciate ligament consists of the anterior lateral bundle and posterior medial bundle, the anatomic reconstruction is hardly performed only by single tunnel reconstructing method. So this stud is to establish the model of double-bundle and double-tunnel with semitendinosus tendon and to investigate its clinical effects after clinic rebuild operation .Method(1)To built the model of double-bundle and double-tunnel: Dissected semitendinosus tendon on corpse, and longitudinally split it into two bundles for double-bundle reconstructing tendon. Drilled two paralleled tunnels on tibia for the tendon of reconstructing anterior lateral bundle and posterior medial bundle of posterior cruciate ligament.(2) Recovered posterior cruciate ligament on operation: The 19 patients with damage of the posterior cruciate ligament were operated with semitendinosus tendon under arthroscopy . after two semitendinosus tendons were respectively imported the tunnels, then fixed them respectively at flexion 90°and 0°~10°with absorbable interference screws. After 9-35 months of the operation ,we make a follow-up visit to all patients. Applied Lyshoim score and measured the distance of shinbone displacement backward at flexion 0o, 45o and 90o to evaluate functional recovery after operation.Result Comparing the displacement of reconstructed posterior cruciate ligament with that of normal posterior cruciate ligament, we found that both were within 5mm checked at two different forced positions, however, after cutting the posterior cruciate ligament the displacement of shinbone exceeded that of reconstructed posterior cruciate ligament, which illustrated the stability of reconstructed posterior cruciate ligament .The Lysholm score of 19 cases after 9-35 months of the operation was 93.6±3.2, while the preoperative score was 49.6±2.7. The displacement of shinbone backward was 3.4±0.6mm at flexion 0o, 3.9±0.4 at flexion 45o, 4.2±0.5mm at flexion 90o respectively. The results indicated that the postoperative function was significantly recovered.Conclusion (1) Through observation and measurement on semitendinosus tendon and reconstruction of the model, it is theoretically practicable means that reconstructing posterior cruciate ligament with semitendinosus tendon using double-bundle double-tunnel model. (2) The double-bundle double-tunnel model can completely replace previous method using double transplants. (3) The result of the clinic follow-up visit indicates that the functional rehabilitation of reconstructed posterior cruciate ligament using double-bundle double-tunnel model is satisfied, which is possible to popularizeing on clinic.