Isolated posterior cruciate ligament aplasia: a case report

Posterior Cruciate Ligament Agenesis Requiring Surgical Reconstruction

“…In all four of these cases, the patients were found to be adults and treated conservatively with successful resolution of symptoms. 1-4 Our case differed in that our patient had symptomatic pain starting from childhood and continuing despite repeated courses of physical therapy. Our case suggests that a patient who demonstrates continued instability and recurrent symptoms over time may require surgical intervention because the presence of continued symptoms could indicate medial joint space wear from altered biomechanics and accelerated development of arthritis.…”

“…12,[22][23][24][25] Some reports of surgical intervention for reconstruction of cruciate ligament agenesis may be fraught with technical difficulties and a high percentage of failure or poor results. 2 In our review of the literature, we found four case reports that detailed incidental findings of isolated PCL agenesis in patients who…”

“…Agenesis of the PCL in isolation is a rare phenomenon. 1 2 3 4 It is more commonly associated with other abnormalities, including tibial spine hypoplasia, femoral condyle hypoplasia, meniscofemoral ligament hypoplasia/hyperplasia, fibular hemimelia, and meniscal abnormalities. 5 6 7 8 A classification system has been established for cruciate ligament agenesis but does not account for agenesis of the PCL alone.…”

“… 12 , 22 23 24 25 Some reports of surgical intervention for reconstruction of cruciate ligament agenesis may be fraught with technical difficulties and a high percentage of failure or poor results. 2 In our review of the literature, we found four case reports that detailed incidental findings of isolated PCL agenesis in patients who presented with knee pain and clinic findings of positive posterior drawer testing. In all four of these cases, the patients were found to be adults and treated conservatively with successful resolution of symptoms.…”

“…Our case suggests that a patient who demonstrates continued instability and recurrent symptoms over time may require surgical intervention because the presence of continued symptoms could indicate medial joint space wear from altered biomechanics and accelerated development of arthritis. 2,20,23 Our patient experienced repeated recurrence of symptoms with associated laxity found on careful examination, leading to discussion regarding the options for surgical intervention. Given his active lifestyle and refractory decision was made to pursue surgical intervention with arthroscopically assisted PCL reconstruction.…”