Posterior cruciate ligament injuries

Abstract

Posterior cruciate ligament (PCL) injuries occur following both high-velocity trauma (motor vehicle collisions) and low-velocity trauma (sporting injuries) with the most common cause being high-velocity trauma resulting in so-called 'dash board injuries'. In majority of the cases, clinical examination will reveal the presence of a PCL tear; however, magnetic resonance imaging remains the imaging modality of choice if the diagnosis is in doubt. For the most part, isolated PCL tears are relatively benign and can be treated conservatively. PCL avulsion injuries or grade III ruptures may require operative intervention. Postoperative rehabilitation is also an important part of the healing process.

Emerging Updates on the Posterior Cruciate Ligament

“…59 Clinicians use the posterior sag sign to assess posterior tibial translation by placing the patient in a supine position on an examination table with both knees flexed to 90°, hips flexed to 45°, and feet resting on the table. If the PCL is torn, an abnormal contour or sag may be evident at the proximal anterior tibia when viewed from a lateral position, 102 especially in comparison with the normal contralateral knee (Figure 6). 72 The quadriceps active test is performed with the knee placed in 90°of flexion and the foot held in place against the examination table.…”

The quadriceps tendon autograft is an option for primary PCL reconstruction: a systematic review

“…Posterior cruciate ligament (PCL) injuries occur in an estimated 3% to 37% of all knee injuries 1,2 .…”

“…Common mechanisms of injury include noncontact hyperextension of the knee with a plantarflexed foot or the application of a posterior force to the tibia in a flexed knee during motor vehicle collisions (a "dashboard injury") 1 . The variability in reported prevalence of PCL injuries likely represents their underdiagnosis secondary to mild presentations or co-occurrence in trauma settings 2,3 .…”

“…Treatment of PCL injuries is controversial and lacks consensus 3,9,10 . Factors influencing this clinical conundrum include variability in PCL injury severity, concurrent injuries, patient factors, and surgeon's preferences 1 . High-grade PCL tears and multiligamentous knee injuries are associated with instability and early osteoarthritis, and warrant surgical intervention 7,8,11,12 .…”