Functional results of patients with chronic reconstruction of isolated and combined posterior cruciate ligament (PCL) injuries
DOI:
https://doi.org/10.1016/j.rccot.2016.07.006Keywords:
posterior cruciate ligament, isolated injuries, combined injuries, chronic reconstructionAbstract
Background: Surgical procedures for isolated and combined PCL injuries reconstruction have demonstrated modest results, which require more investigation. The objective of this study was to evaluate the functional results for isolated and combined PCL injuries reconstruction.
Materials & Methods: A retrospective cohort study was made in patients with isolated and combined PCL injuries with grade III instability, treated surgically by ligamentary reconstruction by the same surgeon in one surgical time using diverse techniques. The results were evaluated using Lysholm and Tegner functional scales and postoperative clinical assessment. The mean follow was 66.30 ± 48.06 months (range:12.4-158.6).
Results: General cohort of patients was 29 patients (27 men and 2 women), active militarists, and a total of 30 knees: 17 with isolated PCL injury and 13 combined. (PCL + ACL: 3, PCL + PLC: 5, PCL + ACL + PLC: 5). The mean time between injury and surgical reconstruction was 17 months (range: 4-36). Excellent and good functionality in Lysholm score was of 83.4% and with ability of doing recreational activity and/or competitive activity, with Tegner score of 86.7%. There were not significant differences between isolated and combined PCL reconstruction in Lysholm (p = 0.562) and Tegner (p = 0.202) adjusted by confusion variables. Postoperative physical examination revealed normal posterior drawer and tibial step off in 15 knees (50%) and normal posterolateral stability in 4 knees (66%).
Discussion: There is controversy in the surgical treatment of these injuries; evidence does not go toward any particular surgical technique. Different surgical techniques were used in this study, obtaining good functional results, considering they were product of a refined surgical technique, adequate fixation system and rehabilitation. Chronic reconstruction offers huge functional benefits.
Evidence level: IV.
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