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J Am Acad Orthop Surg, Vol 17, No 7, July 2009, 435-446.
© 2009 the American Academy of Orthopaedic Surgeons
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Surgical Treatment of Posterior Cruciate Ligament Tears: An Evolving Technique

Matthew J. Matava, MD, Evan Ellis, MD and Brian Gruber, MD

Dr. Matava is Associate Professor, Department of Orthopedic Surgery, Washington University School of Medicine, Chesterfield, MO. Dr. Ellis is Sports Medicine Fellow, Department of Orthopedic Surgery, Washington University School of Medicine. Dr. Gruber is Orthopaedic Surgeon, Arizona Bone and Joint Specialists, Scottsdale, AZ.

Dr. Matava or a member of his immediate family serves as a paid consultant to or is an employee of ISTO Technologies and Schwartz Biomedical, and has received research or institutional support from Breg. Neither of the following authors nor a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ellis and Dr. Gruber.

Reprint requests: Dr. Matava, Department of Orthopedic Surgery, Washington University School of Medicine, 14532 South Outer Forty Drive, Chesterfield, MO 63017-5701.

Major advances have been made recently in the areas of posterior cruciate ligament (PCL) anatomy and biomechanics, and several basic science studies have attempted to clarify the variables relevant to the optimal methods of PCL reconstruction. The emerging science concerning the PCL relates primarily to the biomechanical benefits of the inlay technique of tibial fixation compared with traditional tunnel fixation, use of one versus two reconstructive graft bundles, location of the femoral tunnels, and the ideal degree of graft tensioning. Despite these advances, the conclusions concerning these relevant issues are often in conflict, even with well-conceived experimental designs. Although basic knowledge regarding evolving reconstructive methods is improving, many questions remain unanswered. As a result, it is difficult to advocate one particular reconstructive technique. The optimal method of PCL reconstruction can be determined only with continued advances in basic science studies and the implementation of carefully conceived clinical trials isolating one reconstructive variable.






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Copyright © 2009 by the American Academy of Orthopaedic Surgeons.