Single-Bundle PCL Reconstruction with Remnant Preservation: Midterm Follow-up

Abstract

Background. Remnant preservation was developed as a routine procedure for posterior cruciate ligament (PCL) reconstruction, but it is not easy. Objectives. Our study aimed to evaluate the outcomes of a minimum 5-years follow-up of remnant preservation PCL reconstruction. Methods. The study was a prospective cohort analysis of 44 patients who underwent PCL reconstruction with remnant preservation and a minimum 5-years follow-up. Outcome parameters included were modified Cincinnati score, Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, degree of laxity (Posterior Drawer Test), single-leg hop test, and knee x-ray findings. Results. The mean diameter of the hamstring autograft was 8 ± 2.04 mm. The mean of Lysholm knee scores increased from 65.15 ± 10.48 to 86.94 ± 4.80. The IKDC subjective score increased from 62.55 ± 18.10 (range, 40–65) to 88.65 ± 3.44 (range, 65–100) points, and the Modified Cincinnati Score from 63.32 ± 13.65 to 86.24 ± 1.64. For Posterior Drawer Test results after surgery, 37 patients (84%) had grade 1, 5 (11%) had grade 2, and 2 (4.5%) had grade 3 of laxity. For the range of motion measurements, 39 (88.6%) patients had normal knee status, 3 (6.8%) presented with flexion deficit >25o, and 1 (2.2%) had a 16o-25o deficit in flexion, and 1 (2.2%) had a 16o-25o deficit in extension. Eight cases had the infection at the local incision site, which was resolved with conservative treatment. Conclusion. Remnant preservation in PCL reconstruction with standard and posteromedial portal at a minimum 5-year assessment showed satisfactory clinical, functional outcome, and radiological evaluation outcomes.