Abstract
Due to their infrequency, injuries to the PCL are often overlooked. In addition to clinical examination, posterior stress X-rays are crucial in the diagnostic algorithm. The stress X-rays can also provide insight into the frequently associated posterolateral instabilities and the phenomenon of fixed posterior drawers. In severe posterior instabilities an arthroscopic PCL reconstruction using an autologous semitendinosus-gracilis graft is performed. In cases with associated posterolateral instabilities, we perform a posterolateral reconstruction using a modified Larson technique in the same setting. In chronic posterior instabilities and varus deformity, a high tibial osteotomy is performed. Posterior instabilities require specific diagnostic pathways, indications and surgical techniques. Therefore, this instability should only be treated by experienced surgeons at specialized centers.
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