The Non-operative Treatment of Acute, Isolated (Partial or Complete) Posterior Cruciate Ligament-Deficient Knees: An Intermediate-term Follow-up Study

HSS Journal

Answorth A. Allen, MD
Russell F. Warren, MD
Russell F. Warren, MD
Attending Orthopaedic Surgeon, Hospital for Special Surgery
Surgeon-in-Chief Emeritus, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College
Thomas L. Wickiewicz, MD

Dipak V. Patel, MD, MSc Orth., MS Orth., FCPS Orth.
Sports Medicine and Shoulder Service
Hospital for Special Surgery

Peter T. Simonian, MD
Sports Medicine and Shoulder Service
Hospital for Special Surgery

Fifty-seven consecutive patients (58 knees) with an acute, isolated, posterior cruciate ligament (PCL) injury were treated non-operatively. Clinical, radiographic, and functional assessment was performed at a mean follow-up of 6.9 years (range 2 to 19.3 years) after the initial diagnosis. At the time of initial documentation of the injury, the posterior drawer test was grade A in 17 knees and grade B in 41 knees. The mean preinjury Tegner activity level was 7 (range 4 to 10).

At latest follow-up, 38 knees had no pain, 14 had mild pain, and 6 had moderate pain on exertion. Fifty-four knees had no swelling, 3 complained of mild, intermittent swelling, and 1 had a moderate swelling on exertion. The posterior drawer test was grade A in 14 knees and grade B in 44 knees. The mean Lysholm-II knee score was 85.2 points (range 51 to 100 points) and the mean Tegner activity level was 6.6 (range 3 to 10). Based on Lysholm-II knee scoring system, the results were excellent in 23 knees (40%), good in 30 knees (52%), fair in 2 knees (3%), and poor in 3 knees (5%). No statistically significant correlation (p = 0.097) was seen between the grade of PCL laxity and Lysholm-II knee score. Plain radiographs showed mild (grade I) medial compartment osteoarthritis (OA) in 7 knees, and moderate (grade II) medial compartment OA in 3 knees. Mild patello-femoral OA was seen in 4 knees. We believe that most patients with acute, isolated PCL injuries do well with non-operative treatment at a mean follow-up of 6.9 years.

This article appears in HSS Journal: Volume 3, Number 2.
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About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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