بررسي نتايج بازسازي ليگامان متقاطع خلفي با استفاده از گرافت تاندون چهار سر به صورت دوباندي

A study of results of reconstructing posterior cruciate ligament using two-bundle graft from quadriceps muscle tendon

Introduction: Many of the knees affected rupture of the posterior cruciate ligament (P.C.L) lack desirable function. Researchers are currently seeking surgical procedures of treating P.C.L rupture, which offer a reliable degree of objective and subjective knee stability after surgery. This study assesses the results of anatomical reconstruction of P.C.L using graft from the tendon of the quadriceps muscle. Materials & Methods: This is a descriptive prospective empirical trial involving 14 patients with clinical diagnosis of P.C.L rupture. The patients underwent arthroscopy to rule out other causes of knee discomfort. The patients complained of knee discomfort in spite of conservative treatment and many sessions of physiotherapy. Subjective symptoms of knee instability, i.e. giving way, pain after long walks and pain during climbing, as well as objective knee instability symptoms as assessed by posterior drawer test at 30° and 90 knee flexion, and neutral rotation were recorded and compared prior to and after surgery. The procedure entailed anatomical reconstruction of P.C.L using grafts taken from the tendon of quadriceps muscle and part of proximal patella. Results: Two of 14 patients were excluded from the study due to their failure to refer for follow-up. The patients included 11 men and 1 woman with a mean age of 23 years. Patients displayed statistically meaningful improvement after surgery as regards subjective symptoms, i.e. giving way, pain after long walks and pain in climbing. Objective knee instability symptoms as evaluated by posterior drawer test at 30° and 90° knee flexion and neutral rotation also showed meaningful improvement compared to pre-surgery findings. Conclusion: Reconstruction of P.C.L is aimed at achieving normal knee kinematics and stability. The procedure used in this study entailed anatomical reconstruction of P.C.L. Given the objective and subjective results obtained, the use of this procedure is recommended by the author as the method of choice for reconstructing P.C.L.