DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164178

Clinical outcome of arthroscopic management of isolated posterior cruciate ligament injuries

Suresh Perumal, Sadem Amer, Prakash Ayyadurai, Arumugam Sivaraman

Abstract


Background: Isolated posterior cruciate ligament (PCL) injuries are considered as benign and treated conservatively. But studies have shown the long term outcomes of these patients are poor. Aim of this study is to determine the functional outcomes, efficacy, and complication of isolated PCL injuries treated by arthroscopic PCL reconstruction or fixation.

Methods: 24 patients, each with an isolated PCL injury, (17 with complete PCL tear and 7 with PCL avulsion fracture) were enrolled in this prospective study. Patients with complete tear underwent PCL reconstruction with hamstring tendon autograft and patients with displaced avulsion fractures underwent arthroscopic fixation with suture bridge technique. Average age at time of surgery was 33 years. Average time from injury to surgery was 1 month. Average follow-up period was 18 months. Patients underwent regular follow-up postoperatively with clinical and radiographic evaluation. Follow-up examinations comprised the Lysholm knee score, the International Knee Documentation Committee (IKDC) score.

Results: Mean preoperative Lysholm score for 24 knees was 41; mean postoperative Lysholm score was 90. Eighteen of 24 patients had excellent results, and 4 patients had good results and 2 patients have fare result at final assessment. IKDC ratings showed significant improvements on subsequent follow ups. In final IKDC ratings, 21 patients were assessed as normal or near normal (grade A or B).

Conclusions: The short-term follow-up, analytical results showed good function after arthroscopic management in isolated PCL injuries. Hence we recommend surgical intervention in isolated PCL injuries.


Keywords


Posterior cruciate ligament, Hamstring tendon autograft, Lysholm knee score, IKDC score

Full Text:

PDF

References


Arnoczky SP, Grewe SR, Paulos LE. Instability of the anterior and posterior cruciate ligaments. Instr Course Lect. 1991;40:199-270.

Andriacchi TP, Andersson GBJ, Fermier RW, Stern D, Galante JO. A study of lower-limb mechanics during stair climbing. J Bone and Joint Surg. 1980;62(5):749–57.

Jacobi M, Reischl N, Wahl P, Gautier E, Jakob RP. Acute isolated injury of the posterior cruciate ligament treated by a dynamic anterior drawer brace. J Bone Joint Surg Br. 2010;92:1381–4.

Fowler PJ, Messieh SS. Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med. 1987;15:553–7.

Montgomery SR, Jared SJ, David R, Frank A. Surgical management of PCL injuries: indications, techniques, and outcomes. Curr Rev Musculoskelet Med. 2013;6(2):115–23.

Chan YS, Yang SC, Chang CH, Chen AC, Yuan LJ, Hsu KY, et al. Arthroscopic reconstruction of the posterior cruciate ligament with use of a quadruple hamstring tendon graft with 3- to 5-year follow-up. Arthroscopy. 2006;22(7):762-70.

Sekiya JK, West RV, Ong Bc, Irrgang JJ, Fu FH, Harner CD. Clinical outcomes after isolated arthroscopic single-bundle posterior cruciate ligament reconstruction. Arthroscopy. 2005;21(9):1042-50.