Posterior Cruciate Ligament (PCL) Versus Combined PCL and Posterolateral Corner Reconstruction in Isolated PCL...

Isolated grade-III posterior cruciate ligament (PCL) injuries are defined as PCL injuries without any other ligamentous pathology that have a posterior translation of ≥12 mm compared with the contralateral knee. The aims of this study were to investigate isolated grade-III PCL injuries and to compare the clinical outcomes of 2 surgical methods.

Patients with a PCL injury between 2008 and 2020 were retrospectively reviewed. Patients with an isolated grade-III PCL injury underwent either PCL reconstruction or combined PCL and posterolateral corner (PLC) reconstruction. Stress radiographs (Telos) and International Knee Documentation Committee (IKDC) subjective score, Lysholm knee score, and Tegner activity scale values were obtained preoperatively and at each follow-up.

Of 448 patients with a PCL injury, 254 patients with an isolated PCL injury were identified. Sixty of the 254 patients had a grade-III posterior translation. Thirty patients were excluded due to a lack of follow-up or medical information, leaving a cohort of 30 patients. The 17 patients who underwent isolated PCL reconstruction (Group I) and the 13 patients who underwent combined PCL and PLC reconstruction (Group II) had a mean age of 36.2 years (range, 16 to 59 years) and 31.8 years (range, 16 to 58 years) (p = 0.438), respectively, with a mean follow-up of 4.9 years (range, 2 to 11.8 years) and 4.3 years (range, 2 to 10 years) (p = 0.623), respectively. In Groups I and II, posterior translation, compared with the contralateral knee, improved from 13.7 ± 1.7 mm to 7.2 ± 3.2 mm (p < 0.0001) and from 14.6 ± 2.0 to 7.1 ± 2.4 mm (p = 0.001), respectively. In Group I, the mean IKDC, Lysholm, and Tegner scores improved from 54.8 to 71.8 (p = 0.001), from 56.7 to 77.9 (p = 0.004), and from 3.8 to 5.5 (p = 0.021), respectively. In Group II, the mean IKDC, Lysholm, and Tegner scores improved from 47.1 to 69.5 (p = 0.003), from 54.2 to 77.8 (p = 0.003), and from 4.0 to 5.2 (p = 0.042), respectively. No differences were observed between the groups.

Patients with an isolated grade-III PCL injury who underwent isolated PCL reconstruction showed significant improvements in subjective and objective outcomes. No significant difference was observed between patients who underwent isolated PCL reconstruction and those who underwent combined PCL and PLC reconstruction.

Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.