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An evaluation of posterior cruciate ligament reconstruction surgery

Abstract
Background: The nature of posterior cruciate ligament (PCL) injuries and the scarcity of data on this issue have
made reports on clinical and epidemiological features of PCL injuries valuable. We aimed to report our experiences
with PCL injuries in our region.
Methods: Any patient who referred with a diagnosis of PCL rupture from 2004 to 2018 to our center, was included
in this report. We evaluated pre- and postoperative outcomes and compared patients with isolated and combined
(multi-ligament) PCL injuries.
Results: Overall, 55 patients were included in our study. Majority of patients were men (87.2%). Mean age of
patients was 28.12 ± 8.53 years old.
Average follow-up period was 28.83 ± 20.62 months and mean duration between trauma and surgery was 27.8 ±
38.0 months. Most common cause of PCL injury was traffic accidents (70.9%) followed by sports injuries (5.5%).
Majority of patients (69.1%) had combined PCL injuries.
Majority of patients underwent single tibial-double femoral tunnel reconstruction (56.4%), followed by single tibial single femoral tunnel (34.5%) reconstruction. Allografts were used in 60% of patient. Average Cincinnati knee rating
scale (CKRC) was 35.87 ± 11.4, which improved significantly after PCL reconstruction (79.45 ± 11.90, p < 0.001). Full
range of motion only existed in 29.1% of patient prior to surgery, which improved after surgery (92.7%, p < 0.001).
Three patients had postoperative arthrofibrosis and motion stiffness, 1 had deep vein thrombosis and 3 patients
had infections. Those with isolated PCL injuries had higher pre-operative CKRS (42.05 ± 8.96 vs. 33.10 ± 11.45, p = 0.006) and lower pre-operative posterior drawer test (2.76 ± 0.43 vs. 3.1 ± 0.6, p = 0.042) compared to those with combined injuries.
Conclusion: Today with advances in surgical techniques, considering treatment of collateral ligament injuries, use
of stronger allografts and more secure fixation methods, better rehabilitation programs and early range of motion,
results of reconstruction of the PCL has become very promising. Accordingly we recommend surgical treatment
even for isolated PCL tears, with the goal to prevent functional deficit and to prevent degenerative arthritis.
Keywords: Posterior cruciate ligament, Reconstruction, Outcome, Iran, Trauma

Authors

Mohammad Raz, , Saman Ghaffari,Alireza Askari,Peyman Arasteh, Elaheh Ziaei Ziabari, and Haleh Dadgostar
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