Posterior cruciate ligament reconstruction: a comparative study of two different methods.

The results of posterior cruciate ligament (PCL) reconstruction with the patellar bone-tendon-bone graft performed in 21 patients between 1984 and 1989 were compared with the results of PCL reconstruction using the iliotibial band performed in 12 patients between 1980 and 1984. Much better results were obtained from the procedure using the patellar tendon. Four factors are considered to be responsible for the improvement: precise preoperative assessment of the pathomechanics of the posterior instability and simultaneous correction of collateral laxities if present; isometric placement of the PCL graft; use of a biomechanically sound graft and its secure fixation in the knee; and the concept of full extension of the knee to protect the graft from undue posterior stress during the early postoperative period.