Arthroscopic Posterior Cruciate Ligament Reconstruction in a Skeletally Immature Patient: A New Technique With Case Report

Treatment of Posterior Cruciate Ligament Injuries in Pediatric and Adolescent Patients

“…Although there is considerable debate in the adult literature regarding transtibial versus tibial inlay techniques, most reports in the pediatric literature have focused on transtibial-based techniques, whether primary repair or reconstruction is pursued. 26,42 However, Bovid et al 12 reported on an all-arthroscopic tibial inlay technique of PCL reconstruction in an 11 year old with a mid-substance tear, in whom good results were seen at 17 months follow-up. The authors note that their technique was modified to decrease the chances of physeal injury, which is of critical importance when managing skeletally immature patients with PCL injuries.…”

“…[7][8][9][10] Likewise, nonoperative treatment has long been the first-line approach to PCL injuries in the pediatric population, partly because of the additional operative risks of physeal injury, which can lead to growth arrest or angular deformity. However, there remains a dearth of literature regarding the treatment of PCL injuries in young patients, and although several case reports and small series have suggested that operative treatment is a feasible management option in select cases, [11][12][13][14][15] to our knowledge no outcome studies have been published or algorithms established to comprehensively guide management decisions for patients in this population with PCL injuries. The purpose of this study was to review the experience at a single, tertiary children hospital with pediatric and adolescent PCL injuries treated operatively either with repair or reconstruction, and separately assess, in a noncomparative fashion, features of a similarly age-matched group of patients with PCL injuries that were managed nonoperatively.…”

Volumetric Damage to the Femoral Physis During Double-Bundle Posterior Cruciate Ligament Reconstruction: A Magnetic Resonance Imaging Computer Modeling Study

“…The indications and techniques for treatment of PCL injury in skeletally immature athletes are evolving, but surgical treatment for PCL injury may cause physeal damage and subsequent growth alteration. 10,11 Recent research has shown that DB ACL reconstruction produces femoral physeal injury during drilling of both the anteromedial and posterolateral tunnels. 9 Allepiphyseal femoral ACL reconstruction can be performed without causing direct injury to the physis.…”

“…8,9 Recent studies have also described different repair and reconstruction techniques for PCL injuries in skeletally immature patients, which have included techniques that use drill holes in the distal femur and proximal tibia. 10,11 Although anatomic 12 and biomechanical studies 13,14 have suggested that double-bundle (DB) PCL reconstruction may produce better outcomes, this type of procedure, if performed in skeletally immature patients, may carry a great risk of physeal injury. Recent research on ACL reconstruction techniques in skeletally immature patients has documented the increased volume of physeal damage in DB versus single-bundle (SB) reconstructive techniques.…”

Surgical Technique: When to Arthroscopically Repair the Torn Posterior Cruciate Ligament

“…Surgery is generally reserved for isolated injuries with Grade 3 laxity or with a MLIK [17][18][19]21]. Recent literature regarding surgical management focuses almost entirely on delayed ligament reconstruction rather than acute repair [2,3,5,7,32,40].…”