Methodist Sports Medicine Center's experience with acute and chronic isolated posterior cruciate ligament injuries.
The treatment of isolated PCL tears remains controversial. Potential exists for long-term subjective and radiographic deterioration with non-operative treatment. The general consensus for treating combined instabilities that involve the PCL is a surgical reconstruction. The authors would also consider a reconstruction in the isolated grade 2 or greater PCL tear for the high demand patient. Because the results of reconstruction are not as certain or predictable for posterior laxity as they are for anterior laxity, caution is in order, however. Patient selection remains critical and may warrant an attempt at nonoperative treatment initially with continued close follow-up to locate those patients, whether subjectively or radiographically, who do poorly. It is these latter patients who would most likely benefit from an autogenous patellar tendon PCL reconstruction for their isolated laxity. Continued follow-up of both non-operative and operative treatments are needed so we can further refine our current recommendations. Future research should include both prospective natural history studies of acute isolated PCL tears treated non-operatively as well as the long-term results of different operative treatments. Sufficient patient numbers and an objective methodology for patient evaluation must be included in studies of these treatments.
Shelbourne
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Methodist Sports Medicine Center, Indianapolis, Indiana.
Rubinstein
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D000208:Acute Disease; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D002908:Chronic Disease; D006801:Humans; D007196:Indiana; D007593:Joint Instability / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology; D017847:Patellar Ligament / Q000637:transplantation; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery