Summary

There were no significant differences between SB and DB PCLR in clinical, radiologic, and survivorship outcomes in a minimum follow-up of 10 years.

Abstract

Background

Biomechanical studies have shown that double-bundle (DB) posterior cruciate ligament reconstruction (PCLR) is better than single-bundle (SB) PCLR in restoring normal biomechanical function and stability. However, most clinical studies reported no differences between the 2 technical methods, and there is yet no long-term clinical comparative study.

Hypothesis

DB PCLR would show superior results and survivorship outcomes to those of SB PCLR in the long-term follow-up.

Methods

Between 2000 and 2008, we retrospectively evaluated 64 patients who underwent primary PCLR and were followed up for a minimum of 10 years. There were 28 patients (mean age, 29.1 ± 12.2 years) who underwent SB PCLR and 36 patients (mean age, 27.0 ± 9.2 years) who underwent DB PCLR. The clinical scores (International Knee Documentation Committee subjective score, Lysholm scores, Tegner activity score), side-to-side difference in stress radiographs, osteoarthritis progression, and survival rate were compared between the SB and DB groups at the last follow-up.

Results

At the final follow-up, all clinical scores showed no significant differences between the SB and DB groups. The side-to-side difference in stress radiographs (SB 5.3 ± 3.5 mm vs. DB 5.0 ± 3.8 mm, P = 0.828) and osteoarthritis progression (SB 14.3% vs. DB 13.9%, P = 0.964) were not different between the 2 groups. The 15-year survival rate was 82.1% for SB PCLR and 83.7% for SB PCLR.

Conclusions

Both the SB and DB techniques for PCLR showed satisfactory long-term clinical results and survivorship outcomes. However, there were no significant differences between SB and DB PCLR in clinical, radiologic, and survivorship outcomes in a minimum follow-up of 10 years.