Background: Complete ruptures of the posterior cruciate ligament
alter knee kinematics and may result in functional limitations with sports and
daily activities. We prospectively evaluated the functional results and knee
stability after posterior cruciate ligament replacement with use of a
two-strand quadriceps tendon-patellar bone autograft and a tibial inlay
Methods: Nineteen patients were followed for a mean of thirty-five
months postoperatively. All had a chronic knee injury, and eight had
additional ligament reconstructions. The results were measured with stress
radiography, arthrometric testing, and two validated knee-rating
Results: Eighteen patients rated the knee condition as improved.
Before surgery, eleven patients had pain with daily activities, but only one
had such pain at the time of the latest follow-up. Significant improvements
were noted for pain, swelling, giving-way, walking, climbing stairs,
squatting, running, jumping, and twisting and turning (all p = 0.05).
Eleven patients returned to low-impact sports, and two patients were able to
participate in strenuous sports without problems. At the time of the latest
follow-up, stress radiography revealed that fourteen knees had =5 mm of
increased posterior tibial translation between the reconstructed and the
contralateral side, three knees had 6 to 10 mm, and two knees had >10 mm.
No knee had an infection, permanent limitation of knee motion, or patellar
Conclusions: Posterior cruciate ligament replacement produced
reasonable subjective, functional, and objective results in this group of
complex, chronic knee injuries. The tibial inlay approach was useful in nine
revisions in which prior tibial tunnels had to be avoided.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.