Abstract

PurposeThe posterior cruciate ligament (PCL) is an important stabilizer of the knee and can be damaged in up to 20% of ligamentous injuries. Numerous techniques for surgical treatment have been described in the literature with none shown to be clearly superior. The aim of this study was to assess the 2-year outcomes of PCL repair with suture tape augmentation.MethodsSeventeen patients undergoing PCL repair with suture tape augmentation were prospectively followed up for a minimum of two years. One patient was lost to follow-up leaving sixteen patients in the final analysis (94.1%). Indications for this procedure were acute Grade III PCL ruptures, symptomatic chronic tears and PCL tears as part of a multi-ligament injury. Exclusion criteria were patients with retracted PCL remnants or poor tissue quality. Patient-reported outcomes were measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12 Item Health Survey (VR-12) and Marx Activity Scale. Patients with any postoperative complications were identified. Mean differences between the outcomes pre-operatively and at two years postoperatively were evaluated using paired t-tests with significance set at p < 0.05.ResultsThe mean KOOS at 2 years was 87.0, 75.5, 93.0, 69.6 and 54.2 for pain, symptoms, ADL, sport/recreation and QOL respectively. These improved significantly from 60.2, 49.8, 65.0, 33.0 and 34.2 preoperatively (p < 0.05). The mean WOMAC scores at 2 years were 91.0, 78.3 and 93.0 for pain, stiffness and function respectively. These improved significantly from 63.0, 51.7 and 65.0 preoperatively (p < 0.01). The VAS score improved from 3.0 to 0.8 (p < 0.01) and the VR-12 score improved from 34.9 to 50.9 at 2 years (p < 0.001). However, the Marx activity scale decreased from 8.7 pre-injury to 6.3 at 2 years (N.S.). One patient (6.3%) suffered a re-rupture.ConclusionPCL repair with suture tape augmentation demonstrates satisfactory patient reported outcome measures at minimum 2-year follow-up. These figures compare favorably with success rates described in the literature for PCL reconstruction techniques. Therefore, PCL repair with suture tape augmentation is an effective treatment option in selected patients.Level of evidenceIV

Highlights

  • Posterior cruciate ligament (PCL) injuries are commonly caused by pre-tibial trauma, hyperflexion, and hyperextension of the knee [3]

  • The aim of this study is to report on the clinical outcomes of the cohort at minimum 2 years following PCL repair with suture tape augmentation

  • The tunnels associated with this PCL repair technique are situated in the same position as the larger tunnels used for autografts or allografts in PCL reconstruction

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Summary

Introduction

Posterior cruciate ligament (PCL) injuries are commonly caused by pre-tibial trauma, hyperflexion, and hyperextension of the knee [3]. Internal bracing of the PCL with suture tape augmentation, similar to ACL internal bracing, reinforces the ligament and acts as a secondary stabilizer [13]. This protects the ligament during the healing phase allowing natural healing whilst permitting early mobilization and accelerated rehabilitation. The proprioceptive properties that are retained in the native PCL could contribute to improved functional recovery and return to sporting activity. Long term, this may have a beneficial effect in preventing the development of early onset posttraumatic osteoarthritis

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