Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study.

Abstract

Background: Although posterior cruciate ligament (PCL) reconstruction is often performed for grade 3 PCL injuries, the effectiveness of different surgical techniques and rehabilitation protocols is a topic of debate.

Purpose/hypothesis: The purpose of this study was to evaluate and compare functional outcomes and residual instability in patients who underwent PCL reconstruction with versus without suture tape augmentation. It was hypothesized was that adding high-resistance suture tape to PCL reconstruction would improve functional scores and reduce postoperative laxity.

Study design: Cohort study; Level of evidence, 3.

Methods: A total of 48 patients were included in the study; all patients underwent PCL reconstruction with an autologous quadriceps tendon graft and had a minimum follow-up of 2 years. Overall, 23 patients were treated with a graft only, while 25 were treated with a graft and suture tape. Patients in the suture tape augmentation group also underwent an accelerated rehabilitation program with earlier range of motion and weightbearing. Patient characteristics, Lysholm scores, posterior tibial laxity on stress radiographs at 90° of knee flexion, and postoperative complications were compared between treatment groups.

Results: No statistically significant differences were found between groups in terms of patient characteristics. Similar results were seen in both groups in terms of postoperative complications. Furthermore, on average, the Lysholm score increased from 1- to 2-year follow-up by 6.99 points (standard error = 0.97 points; P < .001), indicating progressive functional improvement, and posterior tibial laxity decreased from preoperatively to postoperatively by 7.55 mm (standard error = 0.24 mm; P < .001), indicating an improvement in knee stability. Patients in both treatment groups saw significant improvements during the follow-up period in the Lysholm score and posterior tibial laxity (P < .001 for both).

Conclusion: PCL reconstruction with suture tape augmentation and an accelerated rehabilitation protocol did not result in significantly improved functional scores or postoperative laxity compared with isolated PCL reconstruction. The results showed no disadvantage of a more aggressive rehabilitation protocol.