Evaluation and treatment of posterior cruciate ligament injuries

Improved basic science data on the anatomy and biomechanics of the human posterior cruciate ligament have provided the orthopaedic surgeon with new information on which to base treatment decisions. Injuries to the posterior cruciate ligament are reported to comprise approximately 3% of all knee ligament injuries in the general population and as high as 37% in an emergency department setting. While the diagnosis of a posterior cruciate ligament injury can often be made with a physical examination, ancillary studies such as radiographs and magnetic resonance images can be very helpful in detecting associated ligament and bony injuries. In general, most partial (grades I and II) posterior cruciate ligament injuries can be treated nonoperatively. However, surgical reconstruction is usually recommended for those posterior cruciate ligament injuries that occur in combination with other structures. In this review, current surgical techniques of posterior cruciate ligament reconstruction based on anatomic and biomechanical studies will be discussed.