In the Journals

Single-bundle PCL reconstruction can be practical alternative to double-bundle

By providing similar knee stability to the intact condition, single-bundle posterior cruciate ligament reconstruction is a practical alternative to conventional double-bundle posterior cruciate ligament reconstruction, according to study results.

Researchers used a robotic testing system to assess knee joint kinematics in eight fresh-frozen human cadaver knees after arthroscopically assisted posterior cruciate ligament (PCL) reconstruction. Knees were assessed under combinations of applied internal, neutral and external rotational tibial torque and anteroposterior translational forces at 0°, 30°, 60°, 90° and 120° flexion. Conditions tested included intact PCL, single-tunnel PCL reconstruction with anterolateral and posteromedial bundle fixation both at 90° and double-bundle-equivalent. The study’s primary outcome measure was posterior tibial translation.

Results showed double-bundle-equivalent reconstruction under the external tibial torque enabled greater posterior translation across the flexion arc as a whole, as well as at 30° flexion when results were stratified by flexion angle vs. the intact knee. The researchers found no other kinematic differences with single-bundle or double-bundle-equivalent fixation, including with mediolateral translation, coupled tibial rotation or isolated tibial rotation.

Although single-bundle PCL reconstruction was similar to native knee rotational and translational kinematics, double-bundle-equivalent reconstruction permitted increased posterior translation with applied external tibial torque, particularly at lower flexion angles, according to the researchers. – by Casey Tingle

Disclosures: Mutnal received a travel honorarium from Cayenne Medical. Please see the full study for a list of all other authors’ relevant financial disclosures.

By providing similar knee stability to the intact condition, single-bundle posterior cruciate ligament reconstruction is a practical alternative to conventional double-bundle posterior cruciate ligament reconstruction, according to study results.

Researchers used a robotic testing system to assess knee joint kinematics in eight fresh-frozen human cadaver knees after arthroscopically assisted posterior cruciate ligament (PCL) reconstruction. Knees were assessed under combinations of applied internal, neutral and external rotational tibial torque and anteroposterior translational forces at 0°, 30°, 60°, 90° and 120° flexion. Conditions tested included intact PCL, single-tunnel PCL reconstruction with anterolateral and posteromedial bundle fixation both at 90° and double-bundle-equivalent. The study’s primary outcome measure was posterior tibial translation.

Results showed double-bundle-equivalent reconstruction under the external tibial torque enabled greater posterior translation across the flexion arc as a whole, as well as at 30° flexion when results were stratified by flexion angle vs. the intact knee. The researchers found no other kinematic differences with single-bundle or double-bundle-equivalent fixation, including with mediolateral translation, coupled tibial rotation or isolated tibial rotation.

Although single-bundle PCL reconstruction was similar to native knee rotational and translational kinematics, double-bundle-equivalent reconstruction permitted increased posterior translation with applied external tibial torque, particularly at lower flexion angles, according to the researchers. – by Casey Tingle

Disclosures: Mutnal received a travel honorarium from Cayenne Medical. Please see the full study for a list of all other authors’ relevant financial disclosures.