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Acute posterior cruciate ligament injuries
The American Journal of Sports Medicine
|March 1, 1981
Summary
Posterior cruciate ligament injuries often result from significant trauma and associated knee damage. Accurate diagnosis, including arthroscopy, is crucial to avoid complications from "isolated" midsubstance tears, especially before prone surgery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Ligament Injuries
Background:
- Posterior cruciate ligament (PCL) injuries are complex, often associated with other knee ligament damage.
- Understanding the mechanisms and injury patterns is vital for effective treatment.
Purpose of the Study:
- To analyze the characteristics of acute posterior cruciate ligament injuries.
- To evaluate the outcomes of surgical repair, particularly regarding patient positioning and reoperation rates.
- To identify factors contributing to poor surgical results in acute PCL tears.
Main Methods:
- Retrospective review of 102 posterior cruciate ligament injuries (59 acute repairs).
- Profiling of acute injuries by cause, site, associated damage, and clinical findings.
- Analysis of surgical position (prone vs. other) and reoperation data.
- Follow-up of 22 patients.
Main Results:
- Motor vehicle accidents and athletics are common causes.
- Femoral, midsubstance, and tibial avulsion sites were identified.
- High incidence of associated injuries: MCL, capsular, LCL, and ACL tears.
- Prone surgery for presumed isolated tears led to reoperations in 8 of 12 cases.
- Poor outcomes correlated with supposed isolated midsubstance tears and popliteal surgery.
Conclusions:
- Posterior cruciate ligament tears result from high-energy trauma with frequent associated injuries.
- A single, universal physical sign for PCL tears is lacking.
- Arthroscopy and examination under anesthesia are recommended to prevent missed diagnoses and guide surgical approach, especially for suspected isolated midsubstance tears prior to prone popliteal surgery.