Epidemiology of posterior cruciate ligament injuries.
BACKGROUND
The epidemiology of posterior cruciate ligament (PCL) injuries has not been well clarified. Isolated and combined PCL injuries are a frequently missed diagnosis. A better understanding of typical injury mechanisms may help in more accurate diagnosis of these injuries.


METHODS
In this study the epidemiology of PCL insufficiency in 494 patients was retrospectively analysed. Stress-radiography was used to quantify posterior tibial displacement.


RESULTS
The mean age at the time of injury was 27.5+/-9.9 years. Traffic accidents (45%) and athletic injuries (40%) were the most common injury causes. Motorcycle accidents (28%) and soccer-related injuries (25%) accounted for the main specific injury causes. The most common injury mechanisms were dashboard injuries (35%) and falls on the flexed knee with the foot in plantar flexion (24%). The mean side-to-side difference of posterior tibial displacement on posterior stress-radiographs in 90 degrees of flexion was 13.4+/-4.7 mm. According to the posterior displacement values, 232 (47%) patients had isolated PCL ruptures, while 262 (53%) patients with a posterior displacement of >12 mm were classified as having a combined posterior instability. There were significantly more combined PCL lesions due to vehicular trauma as compared with athletic trauma ( p<0.0001).


CONCLUSIONS
In many PCL lesions, initiation of an adequate treatment regimen is delayed despite typical injury mechanisms and symptoms. In the future, a better understanding of the epidemiology of PCL injuries should enable us to diagnose the injury more reliably through a detailed history and a thorough physical and radiographic examination in the acute setting.
Orthopaedische Gemeinschaftspraxis Straubing, Hebbelstr 14a, 94315, Straubing, Germany. strobel@ogp.de
M S
MS
Schulz
K
K
Russe
A
A
Weiler
H J
HJ
Eichhorn
M J
MJ
Strobel
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000601:surgery; D011336:Probability; D011379:Prognosis; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods / Q000706:statistics & numerical data; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution