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

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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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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Key words

  • natural history
  • acute/isolated posterior cruciate ligament injury
  • nonoperative treatment