A Biomechanical Comparison of Posterior Cruciate Ligament Reconstructions Using Single- and Double-Bundle Tibial Inlay Techniques

Abstract

Background: The efficacy of using a double-bundle versus single-bundle graft for posterior cruciate ligament reconstruction has not been demonstrated.

Hypothesis: A double-bundle graft restores knee kinematics better than a single-bundle graft does in tibial inlay PCL reconstructions.

Study Design: Controlled laboratory study.

Methods: Eight cadaveric knees were subjected to 6 cycles from a 40-N anterior reference point to a 100-N posterior translational force at 10°, 30°, 60°, and 90° of flexion. Testing was performed for the intact and posterior cruciate deficient knee as well as for both reconstructed conditions. Achilles tendons, divided into 2 equal sections, were prepared as both single-bundle and double-bundle grafts. Both grafts were employed in the same knee, and the order of graft reconstruction was randomized.

Results: There were no statistical differences in translation between the intact state and either of the reconstructions (P > .05) or between either of the reconstructions at any flexion angle (P > .05).

Conclusion: No differences in translation between the 2 graft options were identified.

Clinical Relevance: The use of a double-bundle graft may not offer any advantages over a single-bundle graft for tibial inlay posterior cruciate reconstructions.