In vitro study of knee stability after two-band two-tunnel posterior cruciate ligament reconstructio

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Objective: To compare the ability of three different reconstruction procedures in restoring the posterior displacement of tibia and the posterior stability of the knee joint from 0° to 120° flexion.Methods: Three posterior cruciate ligaments (PCL)reconstruction procedures were performed, namely twoband two-tunnel reconstruction, one-band anterior tunnel reconstruction and one-band posterior tunnel reconstruction. The posterior displacement of the tibia in relation to the femur was measured when a 200N posterior force was applied.Results: Within the flexion range of 0° to 30°, the displacement in the one-band posterior tunnel reconstruction showed little difference from that of an intact knee (P>0.05). But when the flexion exceeded 30°,especially when it exceeded 60°, the displacement in oneband posterior tunnel reconstruction was much greater than that of an intact knee (P < 0.01 ). In two-band two-tunnel reconstruction and one-band anterior tunnel reconstruction,the displacement was approximately the same as that of an intact knee ranging from 0° to 120° (P > 0.05), while a slight over-restriction might be found at some angles.Conclusions: Two-band reconstruction could effectively restrict the posterior displacement of the tibia and restore anterior, posterior stability of the knee joint within its full range of flexion. One-band anterior tunnel reconstruction also could maintain the posterior stability of the knee, while the result of one-band posterior tunnel reconstruction is the most unsatisfactory.
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