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Two-Bundle Posterior Cruciate Ligament Reconstruction: An In Vitro Analysis of Graft Placement and Tension


 The posterior cruciate ligament (PCL) provides over 90% of the forces that resist posterior tibial translation (Butler et al., 1980). When the PCL is ruptured the resulting change in joint kinematics and kinetics can lead to patello femoral pain and joint arthritic. These changes can effect daily activity requiring reconstruction (Satku et al, 1984). Although the goal of PCL reconstruction is to restore the normal limit of posterior tibial translation (Andrews et al., 1994), there is a frequent recurrence of posterior translation (Markolf et al Part I, 1997). The recurrence is believed to be caused by graft elongation/failure. The failure is probably due to non-uniform load sharing among graft fibers combined with large forces and the loss of strength during remodeling (Markolf et al Part II, 1997). The governing hypothesis of this study is that improving load sharing among graft fibers can reduce graft failures. We are pursuing a technique that divides the graft into two bundles so that the bundles have separate attachments and can be separately tensioned. The purpose of this study was to determine the ability of one and two bundle reconstructions to control posterior translation, and to determine how femoral attachment location affected bundle tension.