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First published on May 11, 2005, doi:10.1177/0363546504273046
This version was published on July 1, 2005
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The American Journal of Sports Medicine 33:976-981 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

A Biomechanical Comparison of Posterior Cruciate Ligament Reconstructions Using Single- and Double-Bundle Tibial Inlay Techniques

John A. Bergfeld, MD*, Scott M. Graham, MD{dagger},{ddagger}, Richard D. Parker, MD*, Antonio D. C. Valdevit, MSc§ and Helen E. Kambic, PhD||

From the * Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, the {ddagger} South County Orthopedic Specialists, Laguna Hills, California, the § Department of Surgery, Lutheran Medical Center, Brooklyn, New York, and the || Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, Ohio

{dagger} Address correspondence to Scott M. Graham, MD, South County Orthopedic Specialists, 24331 El Toro Road, Suite 200, Laguna Hills, CA 92653 (e-mail: sgraham{at}scosortho.com).

Background: The efficacy of using a double-bundle versus single-bundle graft for posterior cruciate ligament reconstruction has not been demonstrated.

Hypothesis: A double-bundle graft restores knee kinematics better than a single-bundle graft does in tibial inlay PCL reconstructions.

Study Design: Controlled laboratory study.

Methods: Eight cadaveric knees were subjected to 6 cycles from a 40-N anterior reference point to a 100-N posterior translational force at 10°, 30°, 60°, and 90° of flexion. Testing was performed for the intact and posterior cruciate deficient knee as well as for both reconstructed conditions. Achilles tendons, divided into 2 equal sections, were prepared as both single-bundle and double-bundle grafts. Both grafts were employed in the same knee, and the order of graft reconstruction was randomized.

Results: There were no statistical differences in translation between the intact state and either of the reconstructions (P > .05) or between either of the reconstructions at any flexion angle (P > .05).

Conclusion: No differences in translation between the 2 graft options were identified.

Clinical Relevance: The use of a double-bundle graft may not offer any advantages over a single-bundle graft for tibial inlay posterior cruciate reconstructions.

Key Words: posterior cruciate ligament (PCL) • double bundle • reconstruction • ligament • knee




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