Current concepts of posterior cruciate ligament reconstruction

Disruption of the posterior cruciate ligament (PCL) occurs in isolation as well as combined with other knee ligament injuries. Isolated PCL injuries most commonly occur due to direct trauma to the anterior tibia while the knee is flexed, such as striking the dashboard during a motor vehicle collision or falling onto a flexed knee. In contrast, combined ligament injuries are typically secondary to higher energy mechanisms, sometimes resulting in knee dislocation. Accurate assessment and treatment depend on a complete history, neurovascular and knee ligament examination, and accurate interpretation of the advanced imaging. A thorough understanding of anatomy and biomechanical function is crucial for the treatment of these injuries. Recent advances in PCL reconstruction have allowed for predictable clinical outcomes. Controversies regarding graft selection, reconstruction technique, and ideal rehabilitation remain open to debate. This current concepts review will summarize the best available evidence in the literature and discuss the authors' preferred treatment of the PCL injured knee. Disruption of the PCL occurs in isolation as well as combined with other knee ligament injuries. Isolated PCL injuries most commonly occur due to direct trauma to the anterior tibia while the knee is flexed, such as striking the dashboard during a motor vehicle collision or falling onto a flexed knee. In contrast, combined ligament injuries are typically secondary to higher energy mechanisms, sometimes resulting in knee dislocation. Accurate assessment and treatment depend on a complete history, neurovascular and knee ligament examination, and accurate interpretation of the advanced imaging. A thorough understanding of anatomy and biomechanical function is crucial for the treatment of these injuries. Recent advances in PCL reconstruction have allowed for predictable clinical outcomes. Controversies regarding graft selection, reconstruction technique, and ideal rehabilitation remain open to debate. This current concepts review will summarize the best available evidence in the literature and discuss the authors' preferred treatment of the PCL injured knee.