Arthroscopic Posterior Cruciate Ligament Reconstruction with Quadriceps Tendon-Patellar Bone Autograft

　　　　　Posterior cruciate ligament (PCL) injuries are more common than we once believed. Indications for surgical reconstruction of PCL include a grade Ⅲ or Ⅳ injury, combined ligaments injuries, and symptomatic posterior instability. Surgical treatment for PCL injury with arthroscopic technique has been developed. But considerable controversy continues in regard to the choice of graft tissues. Autograft (patellar tendon, hamstrings) or allograft (Achilles tendon, patellar tendon) has been generally used. Each graft has its advantage and disadvantage. The purpose of this study is to describe the technique of arthroscopic PCL reconstruction with an alternative autograft, quadriceps tendon-patellar bone graft. The graft is harvested as a 20 mm x 10 mm x 8 mm bone plug of upper patellar bone and 75 mm x 10 mm x 6 mm of central quadriceps tendon, including rectus femoris and partial thickness of vastus intermedius. Arthroscopic PCL reconstruction is performed using two-incision method. The graft is passed from femoral to tibial tunnels with bone plug fixation by interference screw at femoral tunnel and free tendon end fixation by suture and bicortical screw at tibia. Between April 1996 and December 1996, this graft has been used in 15 patients with PCL injuries. The early experience with this graft has been excellent. Patients have been satisfactory postoperatively. Patellofemoral pain is uncommon. There were no limitation on quadriceps strength exercise postoperatively. Donor site morbidity is low. Central quadriceps tendon autograft has the advantage of self-available, easier arthroscopic technique, and comparable graft size. It is a reasonable alternative choice of autograft used for PCL reconstruction.