Arthroscopic reconstruction of the posterior cruciate ligament: A comparison of quadriceps tendon autograft and quadruple hamstring tendon graft

Purpose: Considerable controversies remain on the graft choice and fixation methods in the posterior cruciate ligament (PCL) reconstruction. The purpose of this study was to compare, at minimal 2-year follow-up, the outcomes of PCL reconstruction between using quadriceps tendon autograft and using quadruple hamstring tendon autograft. Type of Study: Case series. Methods: All patients received only PCL reconstruction without combined severe associated posterolateral instability. From 1996 to 1998, there were 24 patients who had a quadriceps tendon autograft, and 30 patients with hamstring tendon autograft. Twenty-two of the quadriceps tendon group and 27 of the hamstring tendon autograft group with 2 more years of complete follow-up were included for final analyses. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, thigh muscle girth and strength, and radiographic evaluation. Results: On the Lysholm knee rating, 86% of patients showed good or excellent results in the quadriceps tendon group and so did 89% of patients in the hamstring tendon group. Fifty-nine percent of the quadriceps tendon group and 56% of the hamstring tendon group revealed a 3- to 5-mm ligament laxity. Two patients with quadriceps tendon grafts and 4 patients with hamstring tendon grafts revealed grade II laxity. The IKDC rating showed no significant difference between the 2 groups in terms of activity level, ligament laxity, and final rating. In the thigh girth side-to-side difference, 82% of the quadriceps tendon group and 78% of the hamstring tendon group had less than a 10-mm difference. Conclusions: Comparable satisfactory results between the 2 surgical groups were shown at a minimal 2 years follow-up. We suggested that both grafts could afford good ligament reconstruction likelihood and that they are reasonably acceptable graft choices for PCL reconstruction.