PCL Reconstruction

PCL Reconstruction

Haseeb Hussain, FCPS, PAKISTAN Malik Ahsan Atta Awan, MBBS,FCPS, PAKISTAN Omar Mohammad Aziz, FCPS, MRCPS, PAKISTAN Umair Ahmad, FCPS orthopaedics, PAKISTAN Ammar Dogar, MBBS, FCPS(Ortho), FACS, FICS , PAKISTAN Umair Ahmed, Fcps orthopedics , PAKISTAN

Ghurki hospital, Lahore, Punjab, PAKISTAN


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

PCL

Diagnosis Method

Sports Medicine


Summary: Comparing Functional Outcomes of Posterior Cruciate Ligament Reconstruction: Bone-Patellar Tendon-Bone Graft Versus Hamstring Graft


Introduction

The posterior cruciate ligament (PCL) is crucial for restraining posterior tibial translation. PCL tears are commonly associated with high-energy trauma, such as motor vehicle accidents or falls onto the knee with the foot in a plantar-flexed position. Various tendon autografts are utilized for PCL reconstruction, with Bone-Patellar Tendon-Bone Graft (BTBG) and Hamstring Graft (HT) being the most frequently used.
Objectives: This study aims to evaluate and compare the functional outcomes of PCL reconstruction using Bone-Patellar Tendon-Bone Graft (BTBG) versus Hamstring Graft (HT).

Methods

We performed a retrospective analysis of patients who underwent PCL reconstruction with either Bone-Patellar Tendon-Bone Graft (BTBG) or Hamstring Graft (HT) between 2010 and 2022.

Results

The study included 90 patients in each group (all men). The average age was 30.75 years (SD = 8.86) for the BTBG group and 27.11 years (SD = 7.54) for the Hamstring group.
80% of patients in the BTBG group resumed work compared to 75% in the Hamstring group (p = 0.599). Residual effects were reported in 10% of patients in each group, with no significant difference (p = 1.000).
Knee pain was reported by 15% of patients in the Hamstring group and 20% in the BTBG group (p = 0.317). The rate of return to daily activities was higher in the BTBG group (85%) compared to the Hamstring group (80%) (p = 0.527). No dislocations occurred in either group.
The mean preoperative range of motion (ROM) was 143.33 degrees (SD = 24.50) in the BTBG group, compared to 138.67 degrees (SD = 49.75) in the Hamstring group. Although the BTBG group had a higher ROM, the difference was not statistically significant (t(16) = 0.90, p = 0.19). Apprehension was reported by 22.2% of patients in both groups, with no significant difference in apprehension between the graft types (Chi-Square = 0.00, p = 1.00).
Functional outcomes were better for Hamstring grafts in terms of pain management scores, with a significant difference (p = 0.029). However, other functional measures, such as range of motion and overall scores, did not show significant differences between the two graft types.

Conclusion

Both Bone-Patellar Tendon-Bone Graft (BTBG) and Hamstring Graft (HT) are effective for PCL reconstruction. Hamstring grafts demonstrated better pain management outcomes, but other functional aspects, including range of motion and return to activities, were similar between the two graft types.