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
