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J Am Acad Orthop Surg, Vol 9, No 5, September/October 2001, 297-307.
© 2001 the American Academy of Orthopaedic Surgeons
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Posterior Cruciate Ligament Injuries: Evaluation and Management

Andrew J. Cosgarea, MD and Peter R. Jay, MD

Dr. Cosgarea is Associate Professor, Department of Orthopaedic Surgery, Johns Hopkins Sports Medicine, Baltimore, Md. Dr. Jay is in private practice in Williamsville, NY.

Reprint requests: Dr. Cosgarea, Johns Hopkins Sports Medicine, Suite 215, 10753 Falls Road, Lutherville, MD 21093.

Posterior cruciate ligament (PCL) injuries commonly occur during sports participation or as a result of motor vehicle accidents. Careful history taking and a comprehensive physical examination are generally sufficient to identify PCL injuries. Most authors recommend nonoperative treatment for acute isolated PCL tears. This involves initial splinting in extension followed by range-of-motion and strengthening exercises. Recovery of quadriceps strength is necessary to compensate for posterior tibial subluxation and to facilitate return to preinjury activity levels. In isolated PCL tears, surgical treatment is reserved for acute bone avulsions and symptomatic chronic high-grade PCL tears. Arthroscopic single-tunnel reconstruction techniques will improve posterior laxity only moderately. Newer double-tunnel and tibial-inlay techniques offer theoretical advantages, but the available clinical results are only preliminary. When a PCL injury occurs in combination with other ligament injuries, most patients will require surgical treatment.




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Copyright © 2001 by the American Academy of Orthopaedic Surgeons.