A Comparison of Single-Bundle versus Double-Bundle Inlay Method Using Quadriceps Tendon-BoneAutograft for Posterior Cruciate Ligament Reconstruction. Arthroscopy

Purpose: This study is to compare, at minimal twoyear follow-up, the clinical outcomes of tibial inlay PCL Reconstruction reconstruction when using single-bundle versus double-bundle Quadriceps tendon-bone. Materials and Methods: A quadriceps tendon graft using for single bundle reconstruction consisted of a 10X10X8mm bone plug and 75x10x6 mm tendon portion. A quadriceps tendon graft using for double bundle reconstruction consisted of a 10x10x8 mm bone plug with one tendon being 75x6x6 mm and the other being 75x4x6mm. From May of 2002 to July of 2003, there were 17 patients using single-bundle method and 21 patients with double-bundle method. Results: Sixteen of single bundle group and 20 of double bundle group with complete follow-up data for at least 2 years were included for final analyses. Clinical assessments included Lysholm knee scores, IKDC scores, thigh muscle girth and strength, and radiographic evaluation. In the Lysholm knee rating, 87.5% of patients demonstrated good or excellent results in the single bundle group, as did 85% of patients in the double bundlegroup. The IKDC rating revealed no difference between two groups in terms of activity level, symptoms, and range of motion. One patient (6.25%) in the single bundle group and 2 patients (10%) in the double bundle group revealed a 3-5mm ligament laxity. One patient with single bundle and one patient with double bundlerevealed grade II laxity. There were no difference in the IKDC rating of normal and nearly normal grading between two groups. With Cybex studies, there is no significant difference in flexor or extensor muscle between two Discussion & Conclusion: The results of cruciate ligament reconstruction are various. tibial tunnel method had the defect of acute turn over the posterior aspect of tibia. Tibial inlay method diminishedthis defect and had a good visual accuracy for tibial footprint of PCL. Double-bundle reconstruction more closely restore the biomechanics of the knee. Quadriceps tendon-bone had the benefits of large, and lower donor site mobility. Comparable results between the two surgical groups were demonstrated at a minimal 2 years follow-up. We regard both methods could afford good ligament likelihood and are reasonably acceptable methods reconstruction.