Posterior cruciate ligament reconstruction: current trends

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• The posterior cruciate ligament (PCL) is crucial for knee stability.
• PCL injuries are common in athletes and can lead to long-term disability.
• Surgical techniques for PCL reconstruction have evolved significantly.

Purpose of the Study:

• To assess current trends in PCL injury treatment among orthopedic surgeons.
• To compare contemporary PCL reconstruction practices with data from 1991.
• To identify surgeon preferences regarding graft choice, fixation, and technique.

Main Methods:

• A 34-question survey was distributed to 78 active members of the Herodicus Society.
• Surgeons reported on indications, graft selection, surgical technique, graft tensioning, and fixation for PCL injuries.
• Responses were analyzed and compared to a similar 1991 survey.

Main Results:

• The majority of surgeons (78%) perform ≤10 PCL reconstructions annually.
• Arthroscopic-assisted technique with a posteromedial portal (49%) and single femoral tunnel (68%) were most common.
• Achilles tendon allograft (43% acute, 50% chronic) and interference screw fixation (67%) were preferred.
• A trend towards Achilles tendon allografts and popularization of double femoral tunnels and tibial inlay/onlay techniques were observed since 1991.

Conclusions:

• Current PCL reconstruction commonly involves single femoral tunnels and Achilles tendon allografts.
• Surgeons performing >10 PCL reconstructions/year were more likely to use double tunnel techniques.
• Practices have shifted towards allografts and more complex techniques compared to 1991.