PCL injuries, although less common than ACL injuries, may be seen in variety of clinical settings. These can usually be diagnosed by the skilled physician through a thorough physical examination and confirmatory radiographic studies. Low-grade, isolated PCL injuries are usually treated nonoperatively with acceptable outcomes. Recent studies, however, suggest that chronic PCL deficiency may lead to progressive joint degeneration and arthritis. Multiple surgical options exist for reconstruction of the PCL, although there is little evidence to date demonstrating that PCL reconstruction significantly alters this natural history. Further research is needed to evaluate surgical techniques and treatment controversies.

8. Amis AA, Bull AM J, Gupte CM, et al: Biomechanics of the PCL and related structures: Posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 2003; 11:271281.

9. Harner CD, Honer J: Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med 1998;26:471-482.

10. Johnson DH, Fanelli GC, Miller MD: PCL 2002: Indications, double-bundle versus inlay technique and revision surgery. Arthroscopy 2002;18:40-52.

11. Shelbourne KD, Carr DR: Combined anterior and posterior cruciate and medial collateral ligament injury: Nonsurgical and delayed surgical treatment. Instr Course Lect 2003;52:413-418.

12. Shelbourne KD, Gray T: Natural history of acute posterior cruciate ligament tears. J Knee Surg 2002;15:103-107.

13. Veltri DM, Warren RF: Isolated and combined posterior cruciate ligament injuries. J Am Acad Orthop Surg 1993;1:67-75.

14. Harner CD, Fu FH, Irrgang JJ, et al: Anterior and posterior cruciate ligament reconstruction in the new millennium: A global perspective. Knee Surg Sports Traumatol Arthrosc 2001;9:330-336.

15. Ma CB, Kanamori A, Vogrin TM, et al: Measurement of posterior tibial translation in the posterior cruciate ligament-reconstructed knee. Am J Sports Med 2003;31:843-848.

16. Cooper DE, Stewart D: Posterior cruciate ligament reconstruction using single-bundle patella tendon graft with tibial inlay fixation. Am J Sports Med 2004;32:346-360.

17. Parolie JM, Bergfeld JA: Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete. Am J Sports Med 1986;14:35-38.

18. Toritsuka Y, Horibe S, Hiro-oka A, et al: Conservative treatment for rugby football players with acute isolated posterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 2004;12:110-114.

19. Gill TJ, DeFrate LE, Wang C, et al: The effect of posterior cruciate ligament reconstruction on patellofemoral contact pressures in the knee joint under simulated muscle loads. Am J Sports Med 2004;32:109-115.

20. Shearn JT, Grood ES, Noyes FR, et al: Two-bundle posterior cruciate ligament reconstruction: How bundle tension depends on femoral placement. J Bone Joint Surg Am 2004;86:1262-1270.

21. Christel P: Basic principles for surgical reconstruction of the PCL in chronic posterior knee instability. Knee Surg Sports Traumatol Arthrosc 2003;11:289-296.

22. Giffin JR, Haemmerle MJ, Vogrin TM, et al: Single- versus double-bundle PCL reconstruction: A biomechanical analysis. J Knee Surg 2002;15:114-120.

23. Margheritini F, Mauro CS, Rihn JA, et al: Biomechanical comparison of tibial inlay versus transtibial techniques for posterior cruciate ligament reconstruction: Analysis of knee kinematics and graft in situ forces. Am J Sports Med 2004;32:587-593.

24. Hoher J, Scheffler S, Weiler A: Graft choices and graft fixation in PCL reconstruction. Knee Surg Sports Traumatol Arthrosc 2003; 11: 297-306.

25. Larson RV Ulmer T: Ligament injuries in children. Instr Course Lect 2003;52:677-680.


Medial Collateral Ligament

Matthew Alan Rappé and Peter Indelicato

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