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The Nonoperative Treatment of Acute, Isolated (Partial or Complete) Posterior Cruciate Ligament-Deficient Knees: An Intermediate-term Follow-up Study

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Abstract

Fifty-seven consecutive patients (58 knees) with an acute, isolated, posterior cruciate ligament (PCL) injury were treated nonoperatively. Clinical, radiographic, and functional assessment was performed at a mean follow-up of 6.9 years (range 2 to 19.3 years) after the initial diagnosis. At the time of initial documentation of the injury, the posterior drawer test was grade A in 17 knees and grade B in 41 knees. The mean preinjury Tegner activity level was 7 (range 4 to 10). At latest follow-up, 38 knees had no pain, 14 had mild pain, and 6 had moderate pain on exertion. Fifty-four knees had no swelling, 3 had mild, intermittent swelling, and 1 had a moderate swelling on exertion. The posterior drawer test was grade A in 14 knees and grade B in 44 knees. The mean Lysholm-II knee score was 85.2 points (range 51 to 100 points) and the mean Tegner activity level was 6.6 (range 3 to 10). Based on Lysholm-II knee scoring system, the results were excellent in 23 knees (40%), good in 30 knees (52%), fair in 2 knees (3%), and poor in 3 knees (5%). No statistically significant correlation (p = 0.097) was seen between the grade of PCL laxity and Lysholm-II knee score. Plain radiographs showed mild (grade I) medial compartment osteoarthritis (OA) in 7 knees, and moderate (grade II) medial compartment OA in 3 knees. Mild patellofemoral OA was seen in 4 knees. We believe that most patients with acute, isolated PCL injuries do well with nonoperative treatment at a mean follow-up of 6.9 years. The level of evidence for this retrospective cohort study is level III.

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Acknowledgments

We thank Eva M. Anisko, BA for her help in collaborating the patient data and Margaret G. E. Peterson, PhD for statistical analysis of the data.

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Author notes

  1. Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth.

    Present address: , 129 Sandpiper Key, Secaucus, NJ, 07094, USA

Authors and Affiliations

  1. Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA

    Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth., Answorth A. Allen MD, Russell F. Warren MD, Thomas L. Wickiewicz MD & Peter T. Simonian MD

  2. Department of Clinical Orthopaedics and Musculoskeletal Research, St. Joseph’s Hospital and Regional Medical Center, 703 Main Street, Paterson, NJ, 07503, USA

    Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth.

  3. Seton Hall University, South Orange, NJ, 07079, USA

    Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth.

  4. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Answorth A. Allen MD, Russell F. Warren MD & Thomas L. Wickiewicz MD

  5. Clinical Orthopaedic Surgery, Weill Medical College of Cornell University, New York, NY, 10021, USA

    Answorth A. Allen MD, Russell F. Warren MD & Thomas L. Wickiewicz MD

  6. Simonian Sports Medicine Clinic, 6121 North Thesta Street, Suite 114, Fresno, CA, 93710, USA

    Peter T. Simonian MD

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  1. Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth.
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Correspondence to Dipak V. Patel MD, MSc Orth., MS Orth., FCPS Orth..

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Patel, D.V., Allen, A.A., Warren, R.F. et al. The Nonoperative Treatment of Acute, Isolated (Partial or Complete) Posterior Cruciate Ligament-Deficient Knees: An Intermediate-term Follow-up Study. HSS Jrnl 3, 137–146 (2007). https://doi.org/10.1007/s11420-007-9058-z

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