Abstract

BackgroundThe nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable. We aimed to report our experiences with PCL injuries in our region.MethodsAny patient who referred with a diagnosis of PCL rupture from 2004 to 2018 to our center, was included in this report. We evaluated pre- and postoperative outcomes and compared patients with isolated and combined (multi-ligament) PCL injuries.ResultsOverall, 55 patients were included in our study. Majority of patients were men (87.2%). Mean age of patients was 28.12 ± 8.53 years old.Average follow-up period was 28.83 ± 20.62 months and mean duration between trauma and surgery was 27.8 ± 38.0 months. Most common cause of PCL injury was traffic accidents (70.9%) followed by sports injuries (5.5%). Majority of patients (69.1%) had combined PCL injuries.Majority of patients underwent single tibial-double femoral tunnel reconstruction (56.4%), followed by single tibial-single femoral tunnel (34.5%) reconstruction. Allografts were used in 60% of patient. Average Cincinnati knee rating scale (CKRC) was 35.87 ± 11.4, which improved significantly after PCL reconstruction (79.45 ± 11.90, p < 0.001). Full range of motion only existed in 29.1% of patient prior to surgery, which improved after surgery (92.7%, p < 0.001).Three patients had postoperative arthrofibrosis and motion stiffness, 1 had deep vein thrombosis and 3 patients had infections.Those with isolated PCL injuries had higher pre-operative CKRS (42.05 ± 8.96 vs. 33.10 ± 11.45, p = 0.006) and lower pre-operative posterior drawer test (2.76 ± 0.43 vs. 3.1 ± 0.6, p = 0.042) compared to those with combined injuries.ConclusionToday with advances in surgical techniques, considering treatment of collateral ligament injuries, use of stronger allografts and more secure fixation methods, better rehabilitation programs and early range of motion, results of reconstruction of the PCL has become very promising. Accordingly we recommend surgical treatment even for isolated PCL tears, with the goal to prevent functional deficit and to prevent degenerative arthritis.

Highlights

  • The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable

  • A recent study reported functional score to be significantly lower among individuals with isolated PCL injuries compared to those with isolated anterior cruciate ligament (ACL) injuries at time of reconstruction [7], yet reconstruction of the PCL makes up only 2–3% of cruciate ligament repairs [9]

  • Especially in patients with isolated PCL tear, posterior drawer test (PDT) was performed in acute flexion of the knee, during which palm of the examining hand was placed on the tibial tuberosity and anterior plateau and fingers of the same hand were placed on the patella and femoral condyles, while pushing the tibia back by the palm, posterior translation of the tibial plateau in relation to the femoral condyles was felt

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Summary

Introduction

The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have made reports on clinical and epidemiological features of PCL injuries valuable. Incidence of posterior cruciate ligament (PCL) injuries is variable. These injuries account for an estimated 1 to 47% of all acute knee ligament injuries [1,2,3,4,5] and 3% of all outpatient visits for knee injuries [4]. A recent study reported functional score to be significantly lower among individuals with isolated PCL injuries compared to those with isolated anterior cruciate ligament (ACL) injuries at time of reconstruction [7], yet reconstruction of the PCL makes up only 2–3% of cruciate ligament repairs [9]

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