title: Augmentation or reconstruction of PCL? A quantitative review.
abstract: OBJECTIVE
  The purpose of this quantitative review is to document effectiveness and complications of posterior cruciate ligament (PCL) surgery and compare outcomes, advantages and disadvantages of reconstructive and augmentation procedures.
  
  
  METHODS
  A systematic literature search was performed in PubMed, Medline, Ovid, Google Scholar and Embase databases using the combined keywords "PCL reconstruction," "PCL augmentation," "clinical outcomes" and "functional outcomes" with no limit for year of publication. Articles were included if they reported data on clinical, functional and imaging outcomes who had undergone reconstruction or augmentation of the PCL for management of PCL injuries. Two authors screened the selected articles for title, abstract and full text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all articles was assessed by two authors according to the Coleman methodology score. The critical appraisal was made using the Physiotherapy Evidence Database (PEDro) scale.
  
  
  RESULTS
  A total of 34 studies, 22 retrospective, 9 prospective and 5 were randomized control trials were included by full text. The modified Coleman methodology score averaged 70.8 (SD 6.5), median 73 (range from 60 to 82). At IKDC assessment, the average rate of normal (A) and nearly normal (B) outcomes was 89.8% (SD 4.2) (from 85 to 93%; median 91.4) after PCL augmentation and 80.1% (SD 12.4) after PCL reconstruction (from 57.2 to 100%; median 81.8 %) were rated as normal (A) and nearly normal (B). The average Lysholm Knee Scores after PCL augmentation were 93.1 points (SD 1.9) and ranged from 82.1 to 94.2 (median 90.5) after PCL reconstruction. The KT 1000 difference improved from an average preoperative difference of 8.8 mm (SD 0.9) to an average postoperative of 2.1 mm (SD 0.6) after PCL augmentation (average improvement of 6.7 mm (SD 4.7)) and from 8.2 (SD 3.6) to 2.3 mm (SD 2.0) (average improvement of 5.9 mm SD 4.2) after PCL reconstruction. Postoperatively, the Telos stress radiographic side to side difference averagely improved by 8.6 mm (SD 6.1) after PCL augmentation, from 11.1 mm (SD 1.4) to 2.5 mm (SD 0.4), and by 8.0 mm (SD 5.7) after PCL reconstruction, from 11.5 mm (SD 2.2) to 3.5 mm (SD 1.3).
  
  
  CONCLUSIONS
  Augmentation and reconstruction procedures are grossly equivalent, but more data examining the long-term functional status, recovery to preinjury daily and sport activities and occurrence of degenerative changes are needed.
  
  
  METHODS
  IV.
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy. a.delbuono@unicampus.it
authors: Angelo
authors: A
authors: Del Buono
authors: Juri
authors: J
authors: Radmilovic
authors: Giuseppe
authors: G
authors: Gargano
authors: Salvatore
authors: S
authors: Gatto
authors: Nicola
authors: N
authors: Maffulli
mesh_terms: D000328:Adult; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous
references: Arthroscopy. 2006 Jul;22(7):762-70
references: 16843813
references: Knee Surg Sports Traumatol Arthrosc. 2007 Jan;15(1):2-8
references: 16799825
references: Am J Sports Med. 2005 Mar;33(3):360-9
references: 15716251
references: J Surg Res. 2012 Mar;173(1):75-82
references: 20888585
references: Am J Sports Med. 1997 Sep-Oct;25(5):648-55
references: 9302470
references: Injury. 2002 Nov;33(9):815-21
references: 12379393
references: Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1045-54
references: 16816985
references: Arthroscopy. 2007 Apr;23(4):420-7
references: 17418336
references: Br Med Bull. 2012;104:91-111
references: 22257853
references: Am J Sports Med. 2004 Mar;32(2):346-60
references: 14977658
references: J Bone Joint Surg Am. 1988 Jan;70(1):88-97
references: 3335577
references: Knee Surg Sports Traumatol Arthrosc. 2009 Feb;17(2):140-9
references: 18925355
references: Arthroscopy. 1996 Oct;12(5):521-30
references: 8902124
references: Scand J Med Sci Sports. 2000 Feb;10(1):2-11
references: 10693606
references: Knee Surg Sports Traumatol Arthrosc. 2010 Nov;18(11):1568-72
references: 20571763
references: South Med J. 2002 Oct;95(10):1153-7
references: 12425500
references: Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1036-42
references: 22105977
references: Am J Orthop (Belle Mead NJ). 2006 Dec;35(12):568-71
references: 17243406
references: Am J Sports Med. 1987 Nov-Dec;15(6):553-7
references: 3425783
references: Arthroscopy. 2004 Apr;20(4):339-45
references: 15067271
references: Arthroscopy. 2009 Jul;25(7):777-82
references: 19560642
references: Arthroscopy. 2002 May-Jun;18(5):496-501
references: 11987060
references: Arthroscopy. 2008 Jun;24(6):650-9
references: 18514108
references: J Clin Epidemiol. 1998 Dec;51(12):1235-41
references: 10086815
references: Arthroscopy. 2003 Nov;19(9):955-62
references: 14608314
references: Am J Sports Med. 2004 Mar;32(2):361-8
references: 14977659
references: Knee. 2011 Dec;18(6):392-5
references: 21144755
references: Orthopedics. 1991 Jun;14(6):687-92
references: 1866350
references: Arch Orthop Trauma Surg. 2012 Mar;132(3):363-70
references: 22057816
references: Aust J Physiother. 2009;55(2):129-33
references: 19463084
references: Am J Sports Med. 2012 Mar;40(3):640-9
references: 22109544
references: Am J Sports Med. 1995 Jul-Aug;23(4):424-30
references: 7573651
references: Arthroscopy. 2005 Sep;21(9):1042-50
references: 16171628
references: Am J Sports Med. 1997 Jul-Aug;25(4):479-85
references: 9240981
references: Phys Ther. 2003 Aug;83(8):713-21
references: 12882612
references: Orthop Surg. 2009 Feb;1(1):66-73
references: 22009784
references: Clin Orthop Surg. 2010 Jun;2(2):76-84
references: 20514264
references: Injury. 2003 Oct;34(10):747-51
references: 14519354
references: Arthroscopy. 2005 Dec;21(12):1436-42
references: 16376231
references: Am J Sports Med. 1996 Jan-Feb;24(1):19-27
references: 8638748
references: Clin Orthop Relat Res. 1997 Feb;(335):224-32
references: 9020222
references: Am J Sports Med. 2011 Mar;39(3):474-80
references: 21098819
references: Arthroscopy. 2005 Nov;21(11):1401
references: 16325098
references: Arthroscopy. 2010 Feb;26(2):223-9
references: 20141985
references: Arthroscopy. 2006 Dec;22(12):1331-1338.e1
references: 17157733
references: Arthroscopy. 2002 Jul-Aug;18(6):603-12
references: 12098121
references: Am J Knee Surg. 1999 Fall;12(4):209-13
references: 10626911
references: Arthroscopy. 2011 Apr;27(4):507-15
references: 21444010
references: Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1023-8
references: 22116263
references: J Orthop Res. 2002 Sep;20(5):984-9
references: 12382963