J Knee Surg 2021; 34(06): 582-586
DOI: 10.1055/s-0040-1722312
Special Focus Section

Double-Bundle Posterior Cruciate Ligament Reconstruction

1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3   Mizzou BioJoint Center, University of Missouri, Columbia, Missouri
,
Joseph Temperato
4   Department of Orthopaedic Surgery, Inspira Medical Center, Vineland, New Jersey
,
James T. Stannard
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3   Mizzou BioJoint Center, University of Missouri, Columbia, Missouri
› Author Affiliations

Abstract

The optimal surgical technique for posterior cruciate ligament (PCL) reconstruction is a topic of debate among knee surgeons. There are many variables to consider including graft selection, graft fixation method, and single- versus double-bundle reconstruction. While there is a need for ongoing research to elucidate which technique yields the best results, this article discusses recent literature on the topic of single- versus double-bundle PCL reconstruction as well as the senior author's preferred reconstruction method.

Authors' Contributions

J.P.S, J.T., and J.T.S. provided substantial contributions to research design, acquisition, analysis, and interpretation of data. J.P.S, J.T., and J.T.S supported in drafting the manuscript and revising it critically. All authors have read and approved the final submitted manuscript.




Publication History

Received: 18 November 2020

Accepted: 20 November 2020

Article published online:
12 February 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Kennedy NI, Wijdicks CA, Goldsmith MT. et al. Kinematic analysis of the posterior cruciate ligament, part 1: the individual and collective function of the anterolateral and posteromedial bundles. Am J Sports Med 2013; 41 (12) 2828-2838
  • 2 Edwards A, Bull AM, Amis AA. The attachments of the fiber bundles of the posterior cruciate ligament: an anatomic study. Arthroscopy 2007; 23 (03) 284-290
  • 3 Anderson CJ, Ziegler CG, Wijdicks CA, Engebretsen L, LaPrade RF. Arthroscopically pertinent anatomy of the anterolateral and posteromedial bundles of the posterior cruciate ligament. J Bone Joint Surg Am 2012; 94 (21) 1936-1945
  • 4 Jacobi M, Reischl N, Wahl P, Gautier E, Jakob RP. Acute isolated injury of the posterior cruciate ligament treated by a dynamic anterior drawer brace: a preliminary report. J Bone Joint Surg Br 2010; 92 (10) 1381-1384
  • 5 Shelbourne KD, Clark M, Gray T. Minimum 10-year follow-up of patients after an acute, isolated posterior cruciate ligament injury treated nonoperatively. Am J Sports Med 2013; 41 (07) 1526-1533
  • 6 Fanelli GC, Beck JD, Edson CJ. Current concepts review: the posterior cruciate ligament. J Knee Surg 2010; 23 (02) 61-72
  • 7 Schumaier A, Minoughan C, Jimenez A, Grawe B. Treatments of choice for isolated, full-thickness tears of the posterior cruciate ligament: A nationwide survey of orthopaedic surgeons. J Knee Surg 2019; 32 (08) 812-819
  • 8 Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients: part II. Arthroscopy 1995; 11 (05) 526-529
  • 9 Becker EH, Watson JD, Dreese JC. Investigation of multiligamentous knee injury patterns with associated injuries presenting at a level I trauma center. J Orthop Trauma 2013; 27 (04) 226-231
  • 10 Fanelli GC, Orcutt DR, Edson CJ. The multiple-ligament injured knee: evaluation, treatment, and results. Arthroscopy 2005; 21 (04) 471-486
  • 11 Zhao JX, Zhang LH, Mao Z. et al. Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: a meta-analysis. J Int Med Res 2015; 43 (02) 149-160
  • 12 Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 1975; (106) 216-231
  • 13 Van Dommelen BA, Fowler PJ. Anatomy of the posterior cruciate ligament. A review. Am J Sports Med 1989; 17 (01) 24-29
  • 14 Ahmad CS, Cohen ZA, Levine WN, Gardner TR, Ateshian GA, Mow VC. Codominance of the individual posterior cruciate ligament bundles. An analysis of bundle lengths and orientation. Am J Sports Med 2003; 31 (02) 221-225
  • 15 LaPrade CM, Civitarese DM, Rasmussen MT, LaPrade RF. Emerging updates on the posterior cruciate ligament: a review of the current literature. Am J Sports Med 2015; 43 (12) 3077-3092
  • 16 Papannagari R, DeFrate LE, Nha KW. et al. Function of posterior cruciate ligament bundles during in vivo knee flexion. Am J Sports Med 2007; 35 (09) 1507-1512
  • 17 Wijdicks CA, Kennedy NI, Goldsmith MT. et al. Kinematic analysis of the posterior cruciate ligament, part 2: a comparison of anatomic single- versus double-bundle reconstruction. Am J Sports Med 2013; 41 (12) 2839-2848
  • 18 Nuelle CW, Milles JL, Pfeiffer FM. et al. Biomechanical comparison of five posterior cruciate ligament reconstruction techniques. J Knee Surg 2017; 30 (06) 523-531
  • 19 Milles JL, Nuelle CW, Pfeiffer F. et al. Biomechanical comparison: single-bundle versus double-bundle posterior cruciate ligament reconstruction techniques. J Knee Surg 2017; 30 (04) 347-351
  • 20 Yoon KH, Bae DK, Song SJ, Cho HJ, Lee JH. A prospective randomized study comparing arthroscopic single-bundle and double-bundle posterior cruciate ligament reconstructions preserving remnant fibers. Am J Sports Med 2011; 39 (03) 474-480
  • 21 Li Y, Li J, Wang J, Gao S, Zhang Y. Comparison of single-bundle and double-bundle isolated posterior cruciate ligament reconstruction with allograft: a prospective, randomized study. Arthroscopy 2014; 30 (06) 695-700