Posterior Cruciate Ligament (PCL) and ACL Reconstruction

►Home
►Appointment Info
►Contact Us
►Laser Hair
►Hormones
►Dr. Darrow Videos

►Prolotherapy
►Acute Pain
►Chronic Pain
►Pain Management
►Types of Chronic Pain
►Pain Management Drugs
►Pain and Acupuncture
►Electrical Stimulation
►Nerve Blocks

►Radio Shows OnLine

PCL injuries and ACL reconstruction
Researchers writing in the medical journal Arthroscopy say "A considerably high number of overlooked or underestimated posterior cruciate ligament (PCL) injuries led to isolated ACL reconstruction."

Weiler A, Jung TM, Lubowicki A, Wagner M, Schottle PB. Management of posterior cruciate ligament reconstruction after previous isolated anterior cruciate ligament reconstruction. Arthroscopy. 2007 Feb;23(2):164-9.

PURPOSE: The aim of our study was to analyze 20 patients who underwent secondary posterior cruciate ligament (PCL) reconstruction after previous isolated anterior cruciate ligament (ACL) reconstruction had been performed. Our analysis sought to assess ACL graft preservation or failure in these patients. A secondary aim of our study was to identify a testing protocol to be used before any surgery that would help diagnose PCL deficiency and avoid unneeded ACL reconstruction.

METHODS: A total of 180 PCL reconstructions were prospectively documented, and 20 patients (11%) were identified who underwent previous isolated ACL reconstruction. Cases were analyzed to determine the quantity of ACL graft failures that had occurred and the need for ACL graft removal due to a fixed posterior subluxation. Patient charts were thoroughly reviewed, so investigators could identify the number of patients with incorrect diagnosis (PCL involvement was overlooked or an intact ACL was replaced) and the number with incorrect management (isolated ACL reconstruction was performed even though PCL involvement was recognized).

RESULTS: A fixed posterior subluxation was present in 4 cases; this necessitated subsequent ACL graft resection in 2 patients to release subluxation prior to PCL reconstruction. In all, 7 ACL grafts failed because of overlooked posterolateral instability. In only 11 of 20 cases, the initial ACL graft could be preserved. ACL reconstruction was performed because of incorrect diagnosis in 16 patients and incorrect management in 4.

CONCLUSIONS: A considerably high number of overlooked or underestimated PCL injuries led to isolated ACL reconstruction, which indicates that diagnostic difficulties still occur among orthopaedic surgeons who are not highly specialized. Beside persistent posterior laxity, a failed ACL graft was the main reason for a second operation, which required bicruciate ligament reconstruction. To avoid incorrect management and incorrect diagnosis, leading to isolated ACL reconstruction in PCL deficiency, we recommend that stress radiography be performed to detect eventual posterior instability.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.

►Back Pain
►Elbow Pain
►Golf Injuries
►Headaches
►Hip Pelvic Pain
►Knee Pain
►Neck Pain
►Shoulder Pain
►Whiplash
►Wrist Pain
►Side Effects of
Prolotherapy

A Multi-Disciplinary Clinic For Professional and Amateur Athletes and Chronic Pain Sufferers
11645 Wilshire Blvd., Suite 120 Los Angeles, CA (310) 231-7000

Patient's stories herein, and the language used, is intended to inform and educate. HOWEVER, it does not imply that you or anyone else will receive the same outcome.

Prolotherapy and other modalities mentioned are medical techniques that may not be considered mainstream. As with any medical procedure, results will vary among individuals, and there could be pain or substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

Neither Dr. Darrow, nor any associate of Joint Rehab offer medical advice on this website. This information is offered for educational purposes only. Do not act or rely upon our information without seeking independent professional medical advice. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate of Joint Rehab. Neither Dr. Darrow, nor any associate of Joint Rehab guarantees the accuracy, completeness, usefulness, or adequacy of any resources, information, apparatus, product, or process available at or from this transmission. The photos in this Web site feature models for illustrative purposes and do not depict real patients.

JOINT REHABILITATION & SPORTS MEDICAL CENTER, INC IS HIPAA COMPLIANT. HIPPA IS SHORT FOR THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT. HIPAA PROTECTS PATIENTS' PRIVACY & PERSONAL HEALTHCARE INFORMATION.