Clinical Research Of Posterior Cruciate Ligament Reconstruction With Autogenous Hamstring Tendon Single Bundle Comparing With Double Bundle Under The Arthroscopy

Objective: To compare the clinical effect of posterior cruciateligament reconstruction with single bundle autogenous hamstring tendon withthe double-bundle under the arthroscopy. Methods:35cases of posteriorcruciate ligament(PCL) rupture underwent reconstruction with autogenoushamstring tendons were retrospectively analyzed in our hospital from Oct.2008to Oct.2012, among of whom,20cases with single bundle reconstruction and15cases with double bundle reconstruction. The range of motion （ROM）ofinvolved knee, Lysholm score, the posterior drawer test (PDT), Lachman test,measured tibia bias with regard to femoral bone with KNEELAX3when kneejoint flexing to30°and90°and subjective evaluation of the patients wereinvestigated postoperatively at6M,1Y,2Y respectively.Results: All cases werefollowed-up with an average of15months (range,6-24months),the patientsreconstructed the PCL with single bundle hamstring tendons postoperationstays in hospital16days，while double bundle reconstruction discharge out17days. The ROM of knee in the single-bundle group were （122.3°±3.8°）、（123.6°±3.4°）、（128.5°±4.3°） postoperatively at6M、1Y、2Y, while the double-bundle group were （123.2°±3.6°）、（125.8°±,4.0°）、（128.4°±4.2°），and comparison between two groups has no statistical significance（P＞0.05）.The average lysholm score improved from42.2±4.2points preoperatively to85.6±2.3，88.0±2.6，90.0±3.0in the single-bundle group postoperatively at6M、1Y、2Y,while the average lysholm score improved from42.0±2.9pointspreoperatively to85.9±3.0，89.1±3.4，90.6±2.6. Tibia relative femur backwardshift of2.17±0.23mm，2.24±0.23mm，2.27±0.25mm when knee joint flexingto30°and90°were2.17±0.22mm，2.21±0.21mm，2.21±0.22mm in thesingle-bundle group, the other group were2.18±0.21mm，2.21±0.21mm，2.25±0.25mm and2.19±0.20mm，2.19±0.21mm，2.21±0.22mm when knee jointflexing to30°and90°at postoperative6M,1Y,2Y respectively. The two groups′PDT test and anti-lachman test were positive in prospective study. In thesingle-bundle group， only one case′s anti-lachman test was suspicious positivein postoperation; PDT test and anti-lachman test were negative in thedouble-bundle group. Swollen of knee was observed3case accounted for15%,and pain of knee was2case, to occupy10％;4cases appeared intumesceof knee joint, to occupy26.7％,3cases had knee pain, but could tolerate,accounted for20%, in the double-bundle group.Conclusion: Reconstruction ofposterior cruciate ligament with autogenous hamstring tendon single-bundle ordouble-bundle can effectively recover the function and stability of knee. The incidence of knee joint swelling and pain， and hospitalization costs in thedouble-bundle group is higher than it in single bundle reconstruction group.Reconstruction PCL with double bundle requires more technique to surgeonand cause more trauma.