Publication
Title
Operative management of isolated posterior cruciate ligament injuries improves stability and reduces the incidence of secondary osteoarthritis : a systematic review
Author
Abstract
Purpose To evaluate the evidence for operative and non-operative management of isolated posterior cruciate ligament (PCL) injuries. Methods Using Pubmed, EMBASE and Cochrane databases, a systematic review was conducted of studies investigating the treatment of isolated PCL injuries published until July 2020. Quality assessment was performed with the Cochrane risk of bias tool (level I), the Newcastle-Ottowa Scale (level II-III) and the National Institute of Health quality assessment tool (level IV). Clinical outcome measures included residual laxity, return to sports, patient-reported outcome measures, subsequent articular degeneration and complications. Results Twenty-seven studies [23 case series, 2 case-control, 1 cohort study and 1 randomized controlled trial (RCT)] including 5197 patients (5199 knees) with a mean age of 29.5 +/- 3.6 years (range 15-68) fulfilled the study requirements. Significantly less residual laxity was found after posterior cruciate ligament reconstruction (PCLR) compared to non-operative management (3.43 vs. 5.47 mm, CI: 1.84-2.23, p < 0.001). Both treatment modalities yielded satisfying functional outcomes and a high return to sports (64-77%, mean: 70.3, CI: 67.8-72.2). Osteoarthritis (OA) occurred less frequently following PCLR (21.5 vs. 44.1%, p < 0.001). Conclusion In the absence of level I RCTs, this systematic review suggests that surgical management for selected isolated PCL injuries is a reasonable option to consider, especially when the surgeon aims at minimizing residual laxity and presumably secondary osteoarthritis.
Language
English
Source (journal)
Knee surgery, sports traumatology, arthroscopy. - Heidelberg, 1993, currens
Publication
Heidelberg : 2022
ISSN
0942-2056 [print]
1433-7347 [online]
DOI
10.1007/S00167-021-06723-4
Volume/pages
30 :5 (2022) , p. 1733-1743
ISI
000695634500001
Pubmed ID
34505176
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Publication type
Subject
External links
Web of Science
Record
Identifier
Creation 19.12.2023
Last edited 15.12.2024
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