Acute augmentation for interstitial insufficiency of the posterior cruciate ligament. A two to five year clinical and radiographic study

Abstract

SummaryBackground: there is need to ascertain clinical and imaging outcomes after posterior cruciate ligament (PCL) augmentation. Methods: we performed a retrospective analysis of clinical, imaging and functional data on 21 physically active males who underwent arthroscopic trans-tibial augmentation of the PCL for symptomatic grade III PCL insufficiency. The average follow-up time was 50 months (24-60 months). The Lysholm knee score was administered to all the patients, ligament laxity was evaluated with the posterior drawer test, the KT-1000 arthrometer, and the anteromedial tibial step-off. Standing antero-posterior, lateral and Merchant's view radiographs were taken preoperatively and at annual follow-up. Results: post-operatively, ligament laxity and Lysholm knee scores were significantly improved than at baseline. Sixteen patients (73%) returned to pre-injury sport activity level, 3 patients (14%) returned to a lower level, 2 had to stop. We found radiographic degenerative changes in 5 of 22 affected knees (23%), with evidence of a statistically significant association between the occurrence of degenerative changes and the interval time from injury to surgery and duration of the follow up. Conclusions: arthroscopic transtibial single bundle autograft hamstring augmentation significantly improves the function of the knee, with an overall satisfactory outcome of 82% at 2-5 years from surgery.

Modified arthroscopic repair of a posterior cruciate ligament tibial avulsion fracture improves IKDC and Lysholm score compared to open reduction

“…Radiograph can provide valuable information to assist clinical diagnosis [ 27 ]. PCL reconstruction was to be a potential alternative surgical method due to the improvement of in bone tunnel fabrication, graft replacement, and graft reinforcement [ 20 – 23 , 33 ]. Compared to tendon to bone healing, bone to bone healing was faster and more reliable [ 25 ], and fracture reduction internal fixation were more easily accepted.…”