Scientific Articles   |    
Isolated and Combined Grade-III Posterior Cruciate Ligament Tears Treated with Double-Bundle Reconstruction with Use of Endoscopically Placed Femoral Tunnels and GraftsOperative Technique and Clinical Outcomes
Stanislav I. Spiridonov, MD1; Nathaniel J. Slinkard, MD1; Robert F. LaPrade, MD, PhD2
1 Department of Orthopaedic Surgery, University of Minnesota, 2515 South 7th Street, Suite R-200, Minneapolis, MN 55454
2 The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO 81657. E-mail address: drlaprade@sprivail.org
View Disclosures and Other Information
Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his institution), from a third party in support of any aspect of this work. One or more of the authors, or his institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

  • Disclosure statement for author(s): PDF

Investigation performed at the University of Minnesota, Minneapolis, Minnesota

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Oct 05;93(19):1773-1780. doi: 10.2106/JBJS.J.01638
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



A variety of techniques have been developed to improve clinical outcomes and objective knee stability following posterior cruciate ligament (PCL) reconstruction. Additional refinements in surgical and rehabilitation techniques are necessary for improvement of both subjective and objective outcomes.


All patients studied underwent endoscopic PCL reconstruction with a double-bundle allograft. All of the allografts were placed into the femoral tunnel through a lateral arthroscopic portal, secured by an all-inside method, and were passed distally through a transtibial tunnel. Modified Cincinnati subjective and International Knee Documentation Committee (IKDC) subjective and objective outcome scores and posterior stress radiographs of the knee were made preoperatively and at the time of final follow-up.


There were a total of thirty-nine patients, including thirty-three male and six female patients, with an average age of thirty-three years. There were seven isolated PCL reconstructions and thirty-two combined reconstructions of the knee. Eight patients were not available for follow-up at a minimum of two years, leaving a cohort of thirty-one patients. Preoperative Cincinnati and IKDC subjective scores averaged 34.5 and 39.3, respectively. These scores improved significantly to 73.2 and 74.3, respectively, at an average of 2.5 years postoperatively. On posterior stress radiographs, the average posterior tibial translation of the knees was 15 mm preoperatively and improved significantly to 0.9 mm postoperatively.


Patients undergoing double-bundle PCL reconstruction with use of endoscopic placement of femoral tunnels had significant improvements in subjective and objective outcome scores and with objective knee stability.

Level of Evidence: 

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Tibiofemoral relationship following anatomic triple-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc Published online Aug 30, 2013.;
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Ohio - OhioHealth Research and Innovation Institute (OHRI)
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research