Postoperative Evaluation of Knees With Posterior Cruciate Ligament Injury Using Patient-Oriented Evaluation Method: Comparison of Single-Bundle and Anatomic Double-Bundle Techniques

Abstract Introduction Using the patient-based QOL evaluation scale SF-36 and conventional assessment methods, we evaluated the postoperative outcome of patients with posterior cruciate ligament (PCL) injury who underwent single-bundle or double-bundle reconstruction, and compared the two reconstruction techniques. Methods 37 male patients with isolated PCL injury who underwent reconstruction were randomized to receive single-bundle reconstruction (group S: n=20) or double-bundle reconstruction (group D: n=17). Before surgery and 6 and 24 months after surgery, patients were evaluated by SF-36 scores, Lysholm score, visual analog scale (VAS), posterior tibial displacement rate, and knee range of motion (ROM). Results For SF-36 evaluation at 6 months post-surgery, the scores of all the subscales improved to above the national standard values in group D, whereas none of the subscale scores reached the national standard values in group S, and three subscale scores were inferior in group S compared to group D. At 24 months post-surgery, improvement of all subscale scores to above the national standard values was achieved in both groups. Lysholm score, VAS score, and posterior tibial displacement rate improved after surgery in both groups, but no significant intergroup differences were observed in all evaluation methods. For knee ROM, residual limitation of flexion was significantly more frequent in group S than in group D at 6 and 24 months post-surgery.Conclusion Arthroscopy-assisted single-bundle PCL reconstruction technique is considered to be a safe procedure with low invasiveness, but despite its widespread use, surgical result is not consistently good. This was attributed to the low reproducibility of the unique course and anatomy of PCL, and the anatomic double-bundle reconstruction technique was proposed aiming to improve treatment outcome. According to the present results, double-bundle reconstruction tended to achieve better restoration at an early stage compared to single-bundle reconstruction, with fewer patients having residual limitation of knee flexion after surgery. Trial registration number of our hospital’s IRB: 27-8.Registered 14 September 2015, retrospectively registered.