title: Outcomes of posterior cruciate ligament treatment: a review of the evidence.
abstract: OBJECTIVE
  The purpose of this systematic review is to assess the current recommendations in an evidence-based manner with regard to posterior cruciate ligament (PCL) reconstruction.
  
  
  METHODS
  We conducted a systematic review of multiple databases, evaluating studies on the outcomes of PCL treatment in isolation and in the multiligamentous injured knee.
  
  
  RESULTS
  Twenty-one studies of isolated PCL reconstructions and 10 studies of combined PCL reconstruction were identified for inclusion. Eight studies reported graft failure as an outcome, with an overall rate of 11.6%. Three studies reported outcomes of single bundle PCL reconstruction using hamstring autograft; there were 12 graft failures in 96 reconstructions (12.5%). There were 2 graft failures in a total of 17 combined PCL/anterior cruciate ligament/posterolateral corner reconstructions (11.8%). In the combined PCL studies, return to preinjury activity level ranged from 19 to 68%. In the isolated PCL studies, 50 to 82% of patients were able to return to preinjury activity level. There were no significant differences in functional outcomes (Lysholm and IKDC). From 37% to 70% of patients in the combined PCL studies had a normal posterior drawer test at final follow-up. One study showed a significant difference in the mean posterior drawer test side-to-side difference between the 7-strand and 4-strand hamstring autograft groups (1.7 vs. 3.7 mm, P<0.05).
  
  
  CONCLUSIONS
  Currently, firm recommendations on what treatment or technique to choose cannot be given based upon the available literature. There is a need for higher-quality clinical studies to guide treatment decisions. Generally good results are reported after PCL reconstruction, but the long-term studies available suggest that normal stability in the majority of patients is not restored.
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021, USA.
authors.forename: Sommer
authors.initials: S
authors.lastname: Hammoud
authors.forename: Keith R
authors.initials: KR
authors.lastname: Reinhardt
authors.forename: Robert G
authors.initials: RG
authors.lastname: Marx
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation; D016118:Anterior Cruciate Ligament / Q000601:surgery; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D007593:Joint Instability; D007718:Knee Injuries / Q000534:rehabilitation* / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D014184:Transplantation, Homologous; D016896:Treatment Outcome