HSS Journal

, Volume 3, Issue 2, pp 137–146

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

  • Dipak V. Patel
  • Answorth A. Allen
  • Russell F. Warren
  • Thomas L. Wickiewicz
  • Peter T. Simonian
Original Article

DOI: 10.1007/s11420-007-9058-z

Cite this article as:
Patel, D.V., Allen, A.A., Warren, R.F. et al. HSS Jrnl (2007) 3: 137. doi:10.1007/s11420-007-9058-z

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.

Key words

natural historyacute/isolated posterior cruciate ligament injurynonoperative treatment

Copyright information

© Hospital for Special Surgery 2007

Authors and Affiliations

  • Dipak V. Patel
    • 1
    • 2
    • 3
    • 7
  • Answorth A. Allen
    • 1
    • 4
    • 5
  • Russell F. Warren
    • 1
    • 4
    • 5
  • Thomas L. Wickiewicz
    • 1
    • 4
    • 5
  • Peter T. Simonian
    • 1
    • 6
  1. 1.Sports Medicine and Shoulder ServiceHospital for Special SurgeryNew YorkUSA
  2. 2.Department of Clinical Orthopaedics and Musculoskeletal ResearchSt. Joseph’s Hospital and Regional Medical CenterPatersonUSA
  3. 3.Seton Hall UniversitySouth OrangeUSA
  4. 4.Hospital for Special SurgeryNew YorkUSA
  5. 5.Clinical Orthopaedic SurgeryWeill Medical College of Cornell UniversityNew YorkUSA
  6. 6.Simonian Sports Medicine ClinicFresnoUSA
  7. 7.SecaucusUSA