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Posterior cruciate ligament reconstruction with the quadriceps tendon in chronic injuries

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope


We reviewed 18 patients (knees) operated on because of chronic PCL insufficiency. Preoperatively all the patients were severely disabled and showed a posterior drawer of 10 mm or more. A quadriceps tendon autograft was implanted using an open technique, direct posterior approach, and fixation to the tibia. A free semitendinosus graft was used to reconstruct the lateral collateral ligament in six knees and the medial collateral ligament in two. The patients were reviewed with a mean follow-up of 3.5 years (range 2–5.5) using the IKDC form. Stability was evaluated by stress radiography using the Telos device. The mean side-to-side difference in posterior tibial displacement at 70° of knee flexion at follow-up was 4.8 mm; the side-to-side difference was less than 5 mm in 77% of cases. A side-to-side difference less than 2 mm in lateral joint line opening was found in five of six knees with a lateral collateral ligament reconstruction. Posterior tibial translation was similar in the knees with and those without collateral ligament reconstruction. Only one patient complained of significant pain and giving-way at follow-up. Patellofemoral crepitation was present in nine knees at follow-up although it was symptomatic only in one. The results of this series suggest that posterior cruciate ligament reconstruction using an autologous quadriceps tendon is a valuable option to reconstruct these severe injuries.

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Aglietti, P., Buzzi, R. & Lazzara, D. Posterior cruciate ligament reconstruction with the quadriceps tendon in chronic injuries. Knee Surg Sports Traumatol Arthrosc 10, 266–273 (2002).

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