Arthroscopic posterior cruciate ligament reconstruction by using hamstring tendon autograft and transosseous screw fixation: minimal 3 years follow-up



The aim of this trial is to prospectively evaluate the outcomes of PCL reconstruction by means of quadruple hamstring tendon autograft with a double-fixation method at minimal 3-year follow-up.

Materials and methods

Only patients who underwent PCL reconstruction without any other concomitant injury were included in this study. A hamstring tendon graft is composed of a quadruple-stranded gracilis tendon and semitendinosus tendon about 10 cm in length. An arthroscopic technique via a two incision and a double-fixation method was applied. Clinical evaluations were performed for 52 patients. Clinical assessment of patients included the Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, thigh muscle evaluation, and radiographic investigation.


On the Lysholm knee score, 90 % of the patients displayed good or excellent rating in the final assessment. In the IKDC rating analyses, 60 % of the patients demonstrated 3–5-mm ligament laxity. For the IKDC final rating, 81 % were normal or nearly normal. Seventy-nine percent of the cases revealed less than a 10-mm difference in thigh girth between their reconstructed and contra lateral limbs.


Arthroscopic PCL reconstruction using quadruple hamstring tendon autograft provides acceptable outcomes at a minimum 3-year follow-up. The four-stranded hamstring tendon graft is suitable in graft size and results in minimal harvesting morbidity. We recommend that quadruple hamstring tendon graft be chosen for PCL reconstruction to achieve good ligament reconstruction. A double-fixation method which has been applied in this trial can be used to provide rigid fixation.

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The authors declare that they have no conflict of interest.

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Correspondence to Hamidreza Aslani.

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Norbakhsh, S.T., Zafarani, Z., Najafi, A. et al. Arthroscopic posterior cruciate ligament reconstruction by using hamstring tendon autograft and transosseous screw fixation: minimal 3 years follow-up. Arch Orthop Trauma Surg 134, 1723–1730 (2014).

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  • Arthroscopy
  • Posterior cruciate ligament
  • Hamstring tendon
  • Graft