Suture Tape Augmentation Improves Posterior Stability After Isolated Posterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Single-Bundle Transtibial Technique

Single-Bundle Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and Transtibial Tubercle Fixation

The posterior cruciate ligament (PCL) is the strongest ligament of the knee and plays an important role in stabilizing the knee joint posteriorly. PCL tears are common injuries in sports injuries and traffic accidents; however, clinical outcomes after PCL reconstruction have not yet met clinicians' expectations, with a high postsurgery failure rate reported. Suture tape augmentation and supplementary fixation have shown ideal biomechanical properties in early studies. In this Technical Note, we describe a surgical technique to reconstruct the PCL with suture tape augmentation and transtibial tubercle fixation; the PCL remnant is also preserved. This technique is deemed to improve posterior stability and ultimate failure load for PCL graft over traditional techniques.

Editorial Commentary: Clinical and Basic Science Evidence Supports the Use of Suture Tape Augmentation of Posterior Cruciate Ligament Reconstruction

Although isolated posterior cruciate ligament (PCL) injuries often can be treated successfully without surgical intervention, in the setting of persistent instability or multiligamentous knee injury, PCL reconstruction is indicated. PCL reconstructions often have resulted in persistent postoperative laxity. Recent research suggests there may be a role for suture tape-augmented grafts, which have demonstrated decreased clinical and radiographic laxity as well as improved rates of return to previous level of activity, as compared with PCL reconstruction alone. Several biomechanical studies also have supported the use of suture tape augmentation in PCL reconstruction, and the use of suture tape augmentation or internal bracing and ligament surgery is gaining widespread popularity. These ultrahigh molecular weight polyethylene/polyester suture tapes have been shown to be safe and effective. We may be at the point at which the evidence supports the use of suture tape augmentation of PCL reconstruction.