Interventions for treating posterior cruciate ligament injuries of the knee in adults

Peccin MS, Almeida GJ. M., Amaro JT, Cohen M, Soares B, Atallah ÁN

Published Online:

January 21, 2009

There is a lack of high quality evidence (randomized controlled trials) for the treatment of PCL injuries of the knee. Observational studies have suggested that isolated PCL injuries may be treated conservatively, with good prognosis. In more severe injuries in which the PCL is injured along with other ligaments in the knee, surgical intervention has been used. However, recommendations based on observational studies alone must be treated with caution. Future research should include randomized controlled trials of surgical and conservative interventions for PCL injuries.

Abstract (click to read)

Background:

Injuries of the posterior cruciate ligament (PCL) of the knee frequently occur in automobile accidents and sports injuries, although they are less frequent overall than injuries of the anterior cruciate ligament (ACL). Some patients show significant symptoms and subsequent articular deterioration, while others are essentially asymptomatic, maintaining habitual function. Management of PCL injuries remains controversial and prognosis can vary widely. Interventions extend from non-operative (conservative) procedures to reconstruction of the PCL, in the hope that the surgical procedure may have a positive effect in the reduction/prevention of future osteoarthritic changes in the knee.

Objectives:

To determine the effectiveness and safety of surgical and conservative interventions for PCL injuries in adults.

Search strategy:

We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (April 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2004), MEDLINE via PubMed (1966 to April 2004), EMBASE (1966 to April 2004), CINAHL (1982 to April 2004), LILACS (1982 to April 2004), SportsDiscus (1975 to April 2004), and reference lists of articles.

Selection criteria:

Randomized or quasi-randomized clinical trials comparing various methods of operative and conservative interventions, and comparisons with each other for the treatment of PCL injuries.

Data collection and analysis:

References found with the search strategy were evaluated independently by two review authors.

Main results:

No randomized or quasi-randomized controlled studies meeting the selection criteria were identified.

Authors' conclusions:

Future research should include randomized controlled trials of acute isolated PCL injuries, or PCL injuries when combined with other ligament injuries of the knee, treated operatively and conservatively. Adequate numbers of patients and an objective methodology for patient evaluation must be used in future studies of these interventions to determine the long-term results.

This record should be cited as:

Peccin MS, Almeida GJ. M., Amaro JT, Cohen M, Soares B, Atallah ÁN. Interventions for treating posterior cruciate ligament injuries of the knee in adults. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD002939. DOI: 10.1002/14651858.CD002939.pub2

Assessed as up to date:

November 20, 2004

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Primary Review Group:

Bone, Joint and Muscle Trauma Group

Health topics:

Orthopaedics & trauma > Soft tissue injuries > Ligament injuries in the knee

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Interventions for treating posterior cruciate ligament injuries of the knee in adults

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