Biomechanical Analysis of a Double-Bundle Posterior Cruciate Ligament Reconstruction

The objective of this study was to experimentally evaluate a single-bundle versus a double-bundle posterior cruciate ligament reconstruction by comparing the resulting knee biomechanics with those of the intact knee. Ten human cadaveric knees were tested using a robotic/universal force-moment sensor testing system. The knees were subjected to a 134-N posterior tibial load at five flexion angles. Three knee conditions were tested: 1) intact knee, 2) single-bundle reconstruction, and 3) double-bundle reconstruction. Posterior tibial translation of the intact knee ranged from 4.9 ± 2.7 mm at 90° to 7.2 ± 1.5 mm at full extension. After the single-bundle reconstruction, posterior tibial translation increased to 7.3 ± 3.9 mm and 9.2 ± 2.8 mm at 90° and full extension, respectively, while the corresponding in situ forces in the graft were up to 44 ± 19 N lower than those in the intact ligament. Conversely, with double-bundle reconstruction, the posterior tibial translation did not differ significantly from the intact knee at any flexion angle tested. This reconstruction also restored in situ forces more closely than did the single-bundle reconstruction. These data suggest that a double-bundle posterior cruciate ligament reconstruction can more closely restore the biomechanics of the intact knee than can the single-bundle reconstruction throughout the range of knee flexion.