Posterior Cruciate Ligament Injuries

Abstract

Soccer is the world’s most popular organised sport with over 200 million males and 21 million females registered with the Federation Internationale de Football Association [International Football Federation (FIFA)]. Despite the widespread distribution of this sports activity and the fact that the knee is the second most frequent location of injury [1, 2], there is a lack of information concerning the distribution of posterior cruciate ligament (PCL) injuries among those who play this activity even though the PCL is the stronger of the cruciate ligaments and has been considered by some to be the primary stabiliser of the knee. Historically, the athletic population has been considered at risk for PCL injury, but interestingly, the reported incidence of this lesion appears to be relatively low. Some have expressed the concern that PCL injuries are underestimated secondary to subtlety of symptoms and physical exam findings. Furthermore, 50–90% of PCL injuries are combined injuries involving, most commonly, the posterolateral structures (PLS) of the knee [3, 4]. Although athletes, and soccer players specifically, can often function at a high level with an isolated PCL injury, combined injuries and severe isolated injuries with persistent symptomatic instability usually require surgical treatment. It has been suggested that isolated PCL injury, if left untreated, may result in disability years later. The natural history of the PCL-deficient knee, however, remains a matter of debate. Furthermore, clinical evidence that current reconstruction techniques significantly alter the stability and function of the PCL-deficient knee is lacking. The purpose of this article is to provide a current overview of the basic science and clinical aspects of PCL injury, focusing on the soccer player population.