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J Knee Surg 2019; 32(06): 506-512
DOI: 10.1055/s-0038-1653947
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment Outcome of Reconstruction for Isolated Posterior Cruciate Injury: Subjective and Objective Evaluations

Satoshi Ochiai
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Tetsuo Hagino
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Shinya Senga
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Takashi Yamashita
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Hirotaka Haro
2   Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
› Author Affiliations
Further Information

Publication History

17 August 2017

08 April 2018

Publication Date:
23 May 2018 (online)

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Abstract

There is no consensus regarding the treatment method and outcome of posterior cruciate ligament (PCL) injury. We hypothesized that although the outcome of PCL reconstruction was favorable in terms of knee stability, the outcome was unsatisfactory in terms of patient-based assessments. The purpose of this study is to evaluate the treatment outcomes of knees that underwent reconstruction for PCL injury by subjective and objective assessments, and to analyze the correlation between various assessments. Twenty-three patients who underwent PCL reconstruction were studied. All reconstructions were performed arthroscopically by the single-bundle technique using a hamstring tendon autograft. Patients were evaluated clinically before operation and 24 months after operation using the 36-Item Short Form Health Survey (SF-36) which is a patient-based health assessment survey, Lysholm score, tibial translation ratio, Visual Analogue Scale (VAS) for pain, and range of motion (ROM) in the knee. The correlation of these assessment methods was analyzed. For the SF-36 survey, significant improvement was observed after operation in only 3 of 7 subscales compared with before surgery. Furthermore, the scores reached the national standard scores in only 3 subscales. While the Lysholm score and tibial translation ratio were improved significantly, no significant improvement in the VAS pain score was observed. For ROM assessment, approximately 30% of the patients had flexion restriction after operation, and the degree of restriction correlated positively with the VAS score. The present results indicated that although the outcome of PCL reconstruction was favorable in terms of knee stability and motor function, the outcome was unsatisfactory in terms of patient-based assessments. Since pain associated with flexion restriction appears to be a poor prognostic factor and there is a dissociation between subjective and objective assessments, improvement of the surgical method is necessary.

Keywords

posterior cruciate ligament - PCL reconstruction - treatment outcome - subjective - objective

Note

Informed consent was obtained from all individual participants included in the study.


Ethical Approval

All procedures performed in this study were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.