Twenty-five patients with posterior cruciate ligament ruptures were tr
eated with either allograft reconstruction alone (10 patients) or with
an allograft-ligament augmentation device composite (15 patients). At
follow-up (mean 45 months) the results were assessed with the Cincinn
ati Knee Rating System. There were no significant differences between
the two groups for symptoms, functional limitations, sports activity l
evels, or the overall rating score. The ligament augmentation device p
rovided no benefit. In both groups, the allograft and the allograft co
mposite restored posterior stability at lower functional knee flexion
angles, but not uniformly at higher flexion angles (70-degrees). Patie
nts with acute ruptures faired significantly better than did those wit
h chronic ruptures because they had lower anterior-posterior displacem
ents and fewer symptoms and functional limitations. We recommend consi
deration of early arthroscopic posterior cruciate ligament reconstruct
ion for acute ruptures in active patients. An immediate knee motion pr
ogram was not deleterious to graft fixation and is recommended.