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Arthroscopic Posterior Cruciate Ligament Reconstruction With Quadriceps Tendon Autograft

Minimal 3 Years Follow-up

Chih-Hwa Chen, MD^*,, Wen-Jer Chen, MD, Chun-Hsiung Shih, MD and Shih-Wei Chou, MD, PhD

From the Department of Orthopaedic Surgery and Department of Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

^* Address correspondence to Chih-Hwa Chen, Chang Gung Memorial Hospital, Department of Orthopaedic Surgery, Kweishan, 333, Taiwan (e-mail: afachen{at}doctor.com).

Background: Various autografts or allografts have been used for posterior cruciate ligament (PCL) reconstruction. Quadriceps tendon-patellar bone autograft is considered a good graft choice.

Hypothesis: Quadriceps tendon-patellar bone graft for PCL reconstruction can achieve a satisfactory clinical outcome after 3 years postoperatively.

Study Design: Retrospective review of prospectively collected data.

Methods: From 1996, the graft has been used in 32 patients. Twenty-nine patients with a minimum of 3 years of follow-up were analyzed.

Results: Twenty-four (83%) patients achieved good or excellent results by Lysholm knee rating. Sixteen (55%) patients could return to moderate or strenuous activity. Twenty-five (86%) patients had ligament laxity of less than 5 mm. Twenty-four (83%) patients were rated as normal or nearly normal by International Knee Documentation Committee (IKDC) guidelines. Twenty-four (83%) and 26 (90%) patients could achieve recovery of extensor and flexor muscle strength to 80% or more of normal knee, respectively. A statistically significant difference exists in thigh girth difference, extensor strength, and flexor strength before and after reconstruction.

Conclusion: Our study revealed satisfactory clinical subjective and objective results at a minimum 3 years follow-up. Quadriceps tendon autograft has the advantage of being self-available, a relatively easier arthroscopic technique, and having a suitable size, making it an acceptable graft choice for PCL reconstruction.

Key Words: posterior cruciate ligament • arthroscopy • quadriceps tendon graft • autograft

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