Time From Injury to Surgery Affects Graft Maturation Following Posterior Cruciate Ligament Reconstruction With Remnant Preservation: A Magnetic Resonance Imaging–Based Study

Remnant‐Preserving Posterior Cruciate Ligament Reconstruction Over Remnant Fibers Using a Figure‐of‐Four Position and a Posterior Trans‐Septal Portal

“…5). The excellent clinical outcomes of remnant-preserving PCL reconstruction have also been confirmed by many other studies 11,14,15,[21][22][23] . For example, Lee et al 11 revealed that PCLR with remnant fiber preservation resulted in successful functional and morphological outcomes.…”

“…They suggested that PCLR with remnant preservation could achieve less graft loosening in view of the reduction of the killer turn effect and the restoration of sensations for joint motion. Liu et al 23 followed up with 43 remnant-preserved PCLR patients for an average of 38.4 months and reported that all clinical scores were improved significantly, with no complications observed. The results of KT-1000 difference revealed a significant decline of posterior laxity, and the MRI evaluation confirmed no ligament retears.…”

Editorial Commentary: Could Time From Injury to Surgery Affect Decision Making for Posterior Cruciate Ligament Reconstruction?

“…Of note, no difference was detected in clinical outcomes or graft appearance. 1 Despite the fact that careful interpretation should be performed for these study outcomes, given the specifics in surgical technique, the use of anterior tibialis allograft, and the rehabilitation protocol, the findings of this study could serve as starting point for future research in the field.…”

“…[7][8][9] According to the findings of this and other studies, remnants can be important for graft maturation and signal intensity. 1,6 The imaging assessment scores used for graft evaluation can provide some insight for graft maturation over time; however, it is unclear whether these data (about graft signal intensity and maturation) can be directly correlated to graft mechanical strength and clinical outcome. Further research should focus on improvement in imaging techniques to develop an effective imaging tool that correlates graft characteristics and maturity with clinical decision making for return to sports.…”

Editorial Commentary: The Posterior Cruciate Ligament Posteromedial Bundle Is Small but Vital to Posterior Cruciate Ligament Biomechanics: Don’t Ignore the Underdog

“…6,7 The distinct attachment sites of the 2 PCL bundles not only are suggestive of their synergistic and co-dominant role in knee biomechanics but also offer a technical advantage for safe tunnel placement when double-bundle reconstruction is attempted. The study by Forsythe et al 5 adds to the series of recent work that has attempted to recognize important aspects in PCL reconstruction, such as the position of the femoral tunnel, 8 the importance of fixation, 9 the timing from injury to reconstruction, 10 the graft bending angle, [11][12][13] the role of the tibial slope, 14 the role of remnant tissue, 15,16 and the optimization of grafts. 17,18 The number of published articles about PCL injury showed an exponential increase in the past decade, reaching 76.9 and 82.9 articles published per year in the PubMed and Scopus databases, respectively (Fig 1).…”