Isolated and Combined Posterior Cruciate Ligament Injuries

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

“…MCL laxity was assessed with valgus stress test at 0°and at 30°knee flexion (graded as 0 for 0-2 mm side-to-side difference, 1+ for 3-5 mm difference, 2+ for 6-10 mm difference, 3+ for more than 10 mm difference) [8,14,30] in addition to the anteromedial rotatory instability test [13]. LCL/PCL laxity was assessed with a varus stress test at 0°and at 30°knee flexion (graded as 0 for 0-2 mm side-to-side difference, 1+ for 3-5 mm difference, 2+ for 6-10 mm difference, 3+ for more than 10 mm difference), external rotation with a posterior drawer test at 90°knee flexion (graded as 0, 1+ , 2+ , 3+), and a dial test at 30°knee flexion (considered positive with side-to-side difference greater than 15°) [7,29]. Functional outcome scores included the International Knee Documentation Committee (IKDC) subjective knee score [1], Lysholm knee score [21], and Knee injury and Osteoarthritis Outcome Score (KOOS) score [27].…”

“…ACL laxity was assessed with the Lachman, anterior drawer (graded as 0 for 0-2 mm side-to-side difference, 1+ for 3-5 mm difference, 2+ for 6-10 mm difference, 3+ for more than 10 mm difference) [16], and pivot shift test (graded as 0 for no pivot, 1+ for ''glide,'' 2+ for clear clunk). PCL laxity was assessed with the posterior drawer test at 908 knee flexion (graded as 0 for 0-2 mm side-toside difference, 1+ for 3-5 mm difference and with anterior medial tibial plateau located anterior to the medial femoral condyle, 2+ for 6-10 mm difference and with anterior medial tibial plateau located flush with the medial femoral condyle, 3+ for more than 10 mm difference and with anterior medial tibial plateau located posterior to the medial femoral condyle) [29]. MCL laxity was assessed with valgus stress test at 0°and at 30°knee flexion (graded as 0 for 0-2 mm side-to-side difference, 1+ for 3-5 mm difference, 2+ for 6-10 mm difference, 3+ for more than 10 mm difference) [8,14,30] in addition to the anteromedial rotatory instability test [13].…”

Anatomic posterior cruciate ligament reconstruction: State of the Art

“…Conversely, PCLR should be performed in cases of isolated symptomatic acute grade III PCL tears, combined reconstructions for multiligament lesions or when combined with repairable meniscal body or root tears in the acute setting. In cases of an acute, displaced PCL bony avulsion, surgical intervention is indicated 52. Avulsion fractures usually involve the tibial attachment and are the main indication for a primary PCL repair.…”

Current Concepts Review

“…This finding was originally thought to indicate injury to the PLC; however, excessive varus and hyperextension during the test may indicate combined PLC plus ACL or PCL injury. 109 A variation on the external rotation recurvatum test requires the examiner to hold the heel of the affected limb while extending the knee from 30°of flexion to full extension. The examiner's other hand grasps the posterolateral aspect of the knee to assess relative hyperextension and external rotation compared with the uninvolved side.…”