PRIMARY REPAIR FOR POSTERIOR CRUCIATE LIGAMENT INJURIES - AN 8-YEAR FOLLOW-UP OF 53 PATIENTS

We reviewed 53 of 58 patients who had primary repairs of posterior cru ciate ligament injuries between 1981 and 1988. Sixteen patients had is olated posterior cruciate ligament ruptures, 16 had complex injuries w ith capsular and collateral ligament involvement, and 21 had additiona l anterior cruciate ligament ruptures. Forty-six patients were treated by transosseous multiple-loop sutures and seven with bony avulsions b y screw osteosynthesis. The mean follow-up time was 7.5 years (range, 3 to 12). All patients were examined subjectively (questionnaire) and objectively (clinical examination, KT-1000 arthrometer, functional tes ting, radiographs, and Cybex II isokinetic strength analysis). The res ults were graded according to the International Knee Documentation Com mittee evaluation form and the Lysholm score. The average Lysholm scor e was 82.4 (range, 40 to 100). Thirty-eight patients returned to their preinjury activities at the same intensity level. The patients' subje ctive assessments were normal or nearly normal in 35 patients. The pos terior drawer test was negative or 1+ in 46 patients. Cybex isokinetic strength analysis revealed a decrease in quadriceps muscle strength o f the involved limb by 10.5% (P < 0.01). Our data suggest that primary repair of posterior cruciate ligament ruptures provides good results after 8 years in approximately two thirds of the patients. Distal liga mentous ruptures, lack of athletic activity, and temporary olecranizat ion correlated with poor results. Bony avulsions, midsubstance or prox imal ruptures, and athletic activity correlated with good results.