Does reconstruction of isolated chronic posterior cruciate ligament injuries restore normal knee function?

Isolated posterior laxity is most often cared for with conservative functional treatment. However, when there is pain or instability, surgical treatment can legitimately be proposed. The objective of this study was to assess the results of surgical treatment for chronic isolated posterior laxity.

Surgical treatment of direct posterior laxity re-establishes sufficient anatomical integrity to stabilize and provide good function to the knee.

This was a retrospective, continuous, single-operator study. Eleven operated patients were retained for this study, all followed up a mean 20.9 months, with a minimum follow-up of 1 year. Subjective and clinical assessments were carried out using the International Knee Documentation Score (IKDC) score. Surgical correction of posterior laxity was measured clinically and radiologically.

The subjective IKDC score increased from 53 preoperatively to 68.5 at the last follow-up (P=0.006). For the objective IKDC score, all knees were classified C or D preoperatively; at the last follow-up, six were A or B and none D. All the knees had preoperative Clancy grade 2 or 3 laxity; after surgery, there were three. According to the IKDC laxity score, eight knees were classified A or B at the last follow-up. The radiographic workup noted a 48.6% (P=0.05) posterior laxity correction on the TELOS test.

Posterior cruciate ligament reconstruction provides partial correction of posterior laxity. However, the subjective result remains insufficient, providing acceptable function for daily life activities but not sports activities.

Level IV, retrospective study.