Management of Posterior Cruciate Ligament Injuries: An Evidence-Based Review. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Bedi, Asheesh; Musahl, Volker; Cowan, James B.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 24:Issue 5(2016)
• Publication Date: 2016-05
• Subjects: arthroscopy -- knee -- knee biomechanics -- multiligamentous knee injury -- posterior cruciate ligament; Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-14-00326
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Isolated injuries of the posterior cruciate ligament are uncommon, are often caused by a posteriorly directed force to the proximal tibia, and result in abnormal knee kinematics and function. A thorough clinical evaluation, including history, physical examination, and imaging, is required to rule out a concomitant structural knee injury. No clear prognostic factors predict outcomes, and ideal management remains uncertain. Nonsurgical management is advocated for isolated grade I or II posterior cruciate ligament injuries or for grade III injuries in patients with mild symptoms or low activity demands. Surgical management is reserved for high-demand athletes or patients in whom nonsurgical management has been unsuccessful. Although biomechanical studies have identified differences between single-bundle, double-bundle, transtibial, and tibial inlay reconstruction techniques, the optimal surgical technique has not been established. No high-quality evidence is available regarding immobilization, weight-bearing, bracing, or rehabilitation protocols for patients treated either nonsurgically or surgically. Additional long-term clinical studies with homogeneous patient populations are needed to identify the ideal management of these injuries.