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Epidemiology of posterior cruciate ligament injuries

Abstract

Background

The epidemiology of posterior cruciate ligament (PCL) injuries has not been well clarified. Isolated and combined PCL injuries are a frequently missed diagnosis. A better understanding of typical injury mechanisms may help in more accurate diagnosis of these injuries.

Methods

In this study the epidemiology of PCL insufficiency in 494 patients was retrospectively analysed. Stress-radiography was used to quantify posterior tibial displacement.

Results

The mean age at the time of injury was 27.5±9.9 years. Traffic accidents (45%) and athletic injuries (40%) were the most common injury causes. Motorcycle accidents (28%) and soccer-related injuries (25%) accounted for the main specific injury causes. The most common injury mechanisms were dashboard injuries (35%) and falls on the flexed knee with the foot in plantar flexion (24%). The mean side-to-side difference of posterior tibial displacement on posterior stress-radiographs in 90° of flexion was 13.4±4.7 mm. According to the posterior displacement values, 232 (47%) patients had isolated PCL ruptures, while 262 (53%) patients with a posterior displacement of >12 mm were classified as having a combined posterior instability. There were significantly more combined PCL lesions due to vehicular trauma as compared with athletic trauma (p<0.0001).

Conclusions

In many PCL lesions, initiation of an adequate treatment regimen is delayed despite typical injury mechanisms and symptoms. In the future, a better understanding of the epidemiology of PCL injuries should enable us to diagnose the injury more reliably through a detailed history and a thorough physical and radiographic examination in the acute setting.

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Acknowledgement

We acknowledge the help of Petra Broschinsky for data acquisition.

Author information

Correspondence to M. S. Schulz.

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Schulz, M.S., Russe, K., Weiler, A. et al. Epidemiology of posterior cruciate ligament injuries. Arch Orthop Trauma Surg 123, 186–191 (2003). https://doi.org/10.1007/s00402-002-0471-y

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Keywords

  • Posterior cruciate ligament
  • Epidemiology
  • Clinical evaluation
  • Stress-radiography