Posterior cruciate ligament injuries managed with internal bracing

Synthetic augmentation in the form of an internal brace is increasingly used to stabilize injured knee ligaments. This study aimed to evaluate the clinical and radiological outcome of patients with knee dislocations treated with a posterior cruciate ligament (PCL) internal brace.

Synthetic suture tape drilled into the femoral and tibial PCL footprints was performed in patients with multiple knee ligament injuries. PCL tears were either repaired or left in situ if not repairable. Patients with chronic injuries, contraindications to magnetic resonance imaging (MRI) scans, or cognitive impairment were excluded. Patient-reported outcome measures (PROMs), range of motion, stress X-Rays, and MRI scans were assessed. An acceptable outcome was defined as a Lysholm score of 84 or more, grade II laxity or less on stress radiographs and a range of motion from full extension to 90° or more of flexion.

Eight patients were included with a median age of 38 years, five were female. No patients had knee flexion less than 90° or an extension deficit of more than 10°. PROMs showed a median Lysholm score of 87. Stress radiographs showed less than 7 mm (Grade I) of posterior translation laxity in all patients. In six patients a follow up MRI scan was obtained, which revealed no healing of the PCL in one patient and only partial healing in three patients.

All patients had stable knees and acceptable PROMs, despite tunnel widening or reaction to synthetic material on MRI in five of the six patients. Factors such as anisometric tunnel position and the absence of PCL tear repair may have contributed to the tunnel widening.