title: Acute isolated injury of the posterior cruciate ligament treated by a dynamic anterior drawer brace: a preliminary report.
abstract: We investigated the role of a functional brace worn for four months in the treatment of patients with an acute isolated tear of the posterior cruciate ligament to determine whether reduction of the posterior tibial translation during the healing period would give an improved final position of the tibia. The initial and follow-up stability was tested by Rolimeter arthrometry and radiography. The clinical outcome was evaluated using the Lysholm score, the Tegner score and the International Knee Documentation Committee scoring system at follow-up at one and two years. In all, 21 patients were studied, 21 of whom had completed one-year and 17 a two-year follow-up. The initial mean posterior sag (Rolimeter measurement) of 7.1 mm (5 to 10) was significantly reduced after 12 months to a mean of 2.3 mm (0 to 6, p < 0.001) and to a mean of 3.2 mm (2 to 7, p = 0.001) after 24 months. Radiological measurement gave similar results. The mean pre-injury Lysholm score was normal at 98 (95 to 100). At follow-up, a slight decrease in the mean values was observed to 94.0 (79 to 100, p = 0.001) at one year and 94.0 (88 to 100, p = 0.027, at two years). We concluded that the posterior cruciate ligament has an intrinsic healing capacity and, if the posteriorly translated tibia is reduced to a physiological position, it can heal with less attentuation. The applied treatment produces a good to excellent functional result.
authors.affiliation: Department of Orthopaedic Surgery, HFR Fribourg Hôpital Cantonal, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland. ortho@mjacobi.ch
authors.forename: M
authors.initials: M
authors.lastname: Jacobi
authors.forename: N
authors.initials: N
authors.lastname: Reischl
authors.forename: P
authors.initials: P
authors.lastname: Wahl
authors.forename: E
authors.initials: E
authors.lastname: Gautier
authors.forename: R P
authors.initials: RP
authors.lastname: Jakob
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D053587:Arthrometry, Articular / Q000379:methods; D001915:Braces / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000628:therapy*; D007719:Knee Joint / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult