Double-Bundle Posterior Cruciate Ligament Reconstruction Using Superficial Quadriceps and Semitendinosus Tendon Autografts
R.D.P.L. Cury, V.N.M. Correa, R.R. Rahal, M.B. Mestriner, A.D.S. Netto, V.M. De OliveiraObjective:
To describe and evaluate a double-bundle posterior cruciate ligament (PCL) reconstruction technique using exclusively autologous grafts as an alternative to allograft-dependent procedures.
Methods:
A surgical technique for anatomic double-bundle PCL reconstruction was developed based on current knowledge of PCL anatomy and biomechanics. The anterolateral bundle was reconstructed using an autologous graft harvested from the superficial portion of the quadriceps tendon (rectus femoris), while the posteromedial bundle was reconstructed with an autologous semitendinosus tendon graft. The technique aims to reproduce the native bundle anatomy and tensioning characteristics while avoiding the use of allografts.
Results:
The proposed technique allows anatomic reconstruction of both functional bundles of the PCL using readily available autologous grafts. It provides adequate graft diameter and length for double-bundle reconstruction, preserves biomechanical principles associated with improved knee stability, and eliminates dependence on tissue banks. The use of distinct graft sources facilitates independent bundle reconstruction and may enhance restoration of posterior and rotational knee stability.
Conclusion:
Double-bundle PCL reconstruction using autologous quadriceps and semitendinosus tendon grafts is a feasible and reproducible technique that avoids the limitations associated with allograft use. This approach represents a viable option for achieving anatomic PCL reconstruction, particularly in settings where allografts are unavailable, while maintaining the biomechanical advantages of double-bundle reconstruction.