Management of Posterior Cruciate Ligament Injuries
- 1 May 2016
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Academy of Orthopaedic Surgeons
- Vol. 24 (5), 277-289
- https://doi.org/10.5435/jaaos-d-14-00326
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.Keywords
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