title: Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament.
abstract: BACKGROUND
  With incorrect or even without treatment, acute injuries of the posterior cruciate ligament (PCL) can lead to chronic instability of the knee joint. After delayed treatment, negative occupational changes and reduced quality of life can occur. These aspects have not yet been investigated. The purpose of this study was to evaluate occupational consequences after isolated reconstruction in cases of chronic PCL insufficiency.
  
  
  RESULTS
  12 patients treated with PCL reconstruction in a single bundle technique, using hamstring tendon grafts, were evaluated. All patients were operated upon at least 3 months after injury. Mean time of follow-up was 51 ± 18.2 months (14-75). Radiological assessment (Telos stress device) showed a side comparison of total translation of 4.5 ± 2.6 mm. Occupational consequences have been evaluated by the classification system "REFA". Median time incapacity for work was 8 weeks. Nearly all patients achieved the mental status of the normal population (SF-36), but physical status was still restricted. A pre- to postoperative improvement of the clinical scores could be seen: Lysholm-Score: 46.4 ± 17.3 to 84.7 ± 14.1, HSS-Score: 74.3 ± 10.5 to 88.3 ± 10.7. Postoperative evaluated scores were: Tegner score: 4.8 ± 1.2, IKDC score: 80.0 ± 16.2, VPS: 3.4 ± 2.7. Patients with low physical load in their workplace described significantly better clinical results in every clinical score (p < .05) and less pain than patients with high physical load prior to the accident (VPS: REFA < 2: 2.4 ± 2.6, REFA ≥ 2: 5.5 ± 1.7; p < 0.05).
  
  
  CONCLUSIONS
  Operative treated patients with a chronic PCL insufficiency achieve an improvement of the clinical result. Patients with low physical load at their workplace achieve less restrictions.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ihle
authors.forename: Atesch
authors.initials: A
authors.lastname: Ateschrang
authors.forename: Dirk
authors.initials: D
authors.lastname: Albrecht
authors.forename: Johannes
authors.initials: J
authors.lastname: Mueller
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Department of Traumatology and Reconstructive Surgery, Eberhard Karls University Tübingen, BG Trauma Center Tübingen, Schnarrrenbergstr, 95, 72076 Tübingen, Germany. Schroeter.steffen@t-online.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Schröter
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D008297:Male; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D013710:Tendons / Q000637:transplantation; D013997:Time Factors; D014182:Transplantation, Autologous; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D016474:Weight-Bearing