Posterior cruciate ligament injuries. Results of early surgical repair.

A retrospective study of 20 patients (19 men and one woman) with clinical diagnosis of posterior cruciate ligament injuries (seen between December 1969 and September 1977) was conducted. Eighteen patients underwent surgery an average of 2.6 days after injury. Tears of the posterior cruciate ligament were confirmed in all patients and a high incidence of associated ligamentous injuries was noted. No cases of truly isolated posterior cruciate injury were found. The posterior drawer sign was the most accurate test for posterior cruciate disruption. Torn posterior cruciate ligaments, as well as associated ligamentous injuries, were repaired to bone when possible. Irreparable disruptions or unstable repairs were reinforced with dynamic tendon transfers. We prefer to use as a tendon transfer the medial one-third of the medial head of the gastrocnemius because it provides static posterior drawer resistance and functions dynamically. The average follow-up period was 30.8 months. A comparison of preoperative and follow-up stability was made and it revealed that all patients exhibited mild residual instability. A functional rating showed that seven patients had excellent results, seven had good, three had fair, and one patient had poor results among those surgically treated. One patient treated conservatively rated good. The other one was lost to followup. The results of our study demonstrate that early surgical repair with dynamic augmentation, as indicated, can lead to acceptable functional results in the majority of knees with posterior cruciate ligament injury.