Isolated posterior cruciate ligament reconstruction: is non-aggressive rehabilitation the right protocol?
BACKGROUND
Reconstruction Surgery of the posterior cruciate ligament (PCL) has not yet been fully standardized, and associated rehabilitation protocols have not been clearly defined. The aim of this study is to report the results of a consecutive series of patients who underwent the same surgical technique for isolated PCL reconstruction and were submitted to the same specific rehabilitation protocol. A non-aggressive rehabilitation protocol which protects the graft from excess mechanical stress produces satisfying and reproducible clinical and laxity results in the knee.


METHODS
Our series included 17 patients who underwent single bundle arthroscopic reconstruction of the PCL with an autologous quadriceps tendon graft and who followed the same non-aggressive rehabilitation protocol. All patients were followed up for an average of 30 months (range 12-60 months). The preoperative evaluation and the last follow-up included objective and subjective IKDC scores as well as the Tegner & Lysholm knee scales. The side to side laxity was measured radiologically with the Telos stress testing device. A statistical analysis was performed to compare preoperative and postoperative results.


RESULTS
Preoperatively, no patients were classified as A or B on the IKDC objective score. At last follow-up visit, 88.2% of patients were classified as A or B. Average side to side anteroposterior laxity was 11.9 mm (range 8-18) in the preoperative evaluation and 3.8mm (range 1-7) in the final follow-up (p=0.01) The average subjective IKDC score was 37.7 before surgery and 74.7 at last follow-up (p< 0.01). The Tegner & Lysholm scores were significantly improved by surgery.


CONCLUSIONS
Although the results are still less successful than ACL reconstruction, successful PCL reconstruction results were obtained with a standardized single bundle reconstruction technique and an adapted specific postoperative rehabilitation protocol. A non-aggressive rehabilitation protocol can limit postoperative mechanical stress on the graft.


METHODS
Retrospective Level IV.
Quelard
B
B
Hauteville Public Hospital Center, Inter Unit, Hauteville, France.
Sonnery-Cottet
B
B
Zayni
R
R
Badet
R
R
Fournier
Y
Y
Hager
J-P
JP
Chambat
P
P
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods; D016896:Treatment Outcome