Posterior cruciate ligament repair seems safe with low failure rates but more high level evidence is needed: a systematic review

Abstract

Purpose To discuss recent literature on posterior cruciate ligament (PCL) repair and report on the clinical and radiological outcomes. Methods A systematic review was conducted according to the PRISMA guidelines. In August 2022, three databases (PubMed, Scopus, and Cochrane Library) were searched for studies on PCL repair by two independent reviewers. Articles published between January 2000 and August 2022 focussing on the clinical and/or radiological outcomes, following PCL repair, were included. Patient demographic data, clinical evaluations, patient‑reported outcome measures, post-operative complications and radiological outcomes were extracted. Results Nine studies met the inclusion criteria, covering 226 patients with a mean age ranging from 22.4 to 38.8 years and mean follow-up periods ranging from 14 to 78.6 months. Seven studies (77.8%) were level IV and two studies (22.2%) were level III. Arthroscopic PCL repair was performed in four studies (44.4%) while the remaining five studies (55.6%) described open PCL repair. In four studies (44.4%) additional suture augmentation was applied. Arthrofibrosis affected a combined total of 24 patients (11.7%; range 0–21.0%) making it the most common complication and the overall failure rate was 5.6%, ranging from 0 to 15.8%. Two studies (22.2%) performed post-operative MRI and confirmed PCL healing. Conclusion This systematic review indicates that PCL repair can be a safe procedure with an overall failure rate of 5.6%, ranging from 0% to 15.8%. However, more high quality research is necessary before widespread clinical implementation is warranted. Level of Evidence IV.

Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

“…The posterior cruciate ligament (PCL) stabilises the knee by resisting excess translation of the tibia posteriorly relative to the femur [1]. PCL injuries are often associated with high-velocity trauma, such as 'dashboard injuries' in motor vehicle collisions or multiligament knee injuries [2]. The gold standard management of a symptomatic grade III PCL tear, or PCL injury with high-grade knee laxity or concomitant capsuloligamentous injury is PCL reconstruction, however, there is far less information on optimal surgical techniques and outcomes after surgery compared to that of anterior cruciate ligament (ACL) reconstruction [3,4].…”