CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(05): 531-539
DOI: 10.1016/j.rboe.2017.12.010
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Thick Graft Versus Double-Bundle Technique on Posterior Cruciate Ligament Reconstruction: Experimental Biomechanical Study with Cadavers[*]

Article in several languages: português | English
1  Faculdade de Medicina, Universidade Federal do Pará, Belém, PA, Brasil
2  Clínica dos Acidentados, Hospital Maradei, Belém, PA, Brasil
3  Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil
,
Alexandre Estevão Vamos Kokron
3  Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil
,
César Augusto Martins Pereira
3  Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil
,
Marco Martins Amatuzzi
3  Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil
› Author Affiliations
Further Information

Publication History

29 September 2017

14 December 2017

Publication Date:
29 October 2019 (online)

Abstract

Objective To evaluate the biomechanical effect of graft thickness compared with the double-bundle technique on posterior cruciate ligament (PCL) reconstruction in human cadaveric knees.

Methods A total of 9 human cadaveric knees were tested in 5 conditions: intact knee (INT); single-bundle reconstruction with a 10-mm quadriceps tendon (SB); double-bundle reconstruction with a 10 mm-quadriceps tendon for the anterolateral bundle and a 7-mm doubled semitendinosus tendon for the posteromedial bundle (DB); single-bundle reconstruction with a 10-mm quadriceps tendon plus a 7-mm doubled semitendinosus tendon (SBT); and PCL-deficient (NoPCL). The posterior tibial translation (PTT) was measured in response to a 134-N posterior tibial load at 0, 30, 60 e 90 of knee flexion.

Results The PTT values of the DB and SBT techniques were always significantly lower (better stability) than those of the SB technique. The PTT values of the SBT technique were significantly lower than those of the DB technique at 60 (p = 0.005) and 90 (p = 0.001).

Conclusions Graft enlargement improves knee stability in isolated PCL reconstructions, whereas the graft division in the two-bundle technique worsens this stability at 60 and 90 of knee flexion. The findings of the present study suggest that knee stability in PCL reconstructions may be improved with the use of thicker grafts in the SB technique rather than performing the DB technique.

* Study conducted at the Medical Research Laboratory (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. Originally published by Elsevier.