A biomechanical comparison of posterior cruciate ligament reconstructions using single- and double-bundle tibial inlay techniques

Background: The efficacy of using a double-bundle versus single-bundle graft for posterior cruciate ligament reconstruction has not been demonstrated. Hypothesis: A double-bundle graft restores knee kinematics better than a single-bundle graft does in tibial inlay PCL reconstructions. Study Design: Controlled laboratory study. Methods: Eight cadaveric knees were subjected to 6 cycles from a 40-N anterior reference point to a 100-N posterior translational force at 10 degrees, 30 degrees, 60 degrees, and 90 degrees of flexion. Testing was performed for the intact and posterior cruciate deficient knee as well as for both reconstructed conditions. Achilles tendons, divided into 2 equal sections, were prepared as both single-bundle and double-bundle grafts. Both grafts were employed in the same knee, and the order of graft reconstruction was randomized. Results: There were no statistical differences in translation between the intact state and either of the reconstructions (P > .05) or between either of the reconstructions at any flexion angle (P > .05). \Conclusion: No differences in translation between the 2 graft options were identified. Clinical Relevance: The use of a double-bundle graft may not offer any advantages over a single-bundle graft for tibial inlay posterior cruciate reconstructions.