RESULTS OF POSTERIOR CRUCIATE LIGAMENT RE PAIR

A retrospective study was performed to evaluate the outcome of operati ve treatment of posterior cruciate ligament (PCL) lesions in 115 patie nts operated on between 1980 and 1989. Follow-up was possible in 89 pa tients at 18-124 months postoperatively (average 76 months). In 65 re- examination was possible, while 24 patients returned a questionnaire. The results of patients who were operated on in the acute state were s uperior to those with chronic instabilities (lysholm 79.9 +/- 18.5 vs 64.3 +/- 22.1; Tegner 5.7 +/- 2.3 vs 4.2 +/- 2.2; instrumented posteri or drawer 5.3 +/- 3.5 mm vs 5.9 +/- 3.8 mm). On the other hand, the pr eoperative scores of symptomatic patients with chronic instabilities ( Lysholm 38.8 +/- 22.0; Tegner 2.1 +/- 1.7) were clearly lower. Extraar ticular procedures (Hughston) slightly improved symptoms in posterolat eral instabilities. Olecranization of the patella had no influence on the results. Interpretation of the data is difficult as there was no m atched group of patients with nonoperative treatment. A reviews of the literature suggests that isolated PCL tears are best treated with con servative management. Only in cases where associated ligamentous injur ies require operative treatment should PCL reconstruction be performed . Chronic posterior instabilities should be treated operatively only i f the patients are severely symptomatic. However, complete restoration of knee stability was usually not achieved with the techniques presen ted in this paper.