Abstract des Autors

The indications for surgical management of complete tears of the PCL have gradually changed as the techniques to address this problem have evolved over the last 2 decades. It has become apparent that complete tears of the PCL, other than the strictly defined isolated tears, generally result in significant clinical disability over time for such patients. With improved technical capacity to reconstruct the PCL in a near-anatomic manner, we have been able to improve the knees of a majority of patients from a clinical perspective. Although it will be many years before we will know the long-term sequelae of both reconstructed and nonreconstructed PCL-injured knees, we believe that the current knowledge base and literature support surgical intervention for the following injuries: acute and chronic PCL-injured knees with associated soft-tissue injuries, PCL avulsion injuries, and injuries that clearly fall outside the envelope of the true isolated PCL injury. Our preferred technique for complete PCL ruptures is the anatomic posterior tibial-inlay method of PCL reconstruction. Although the present data on this technique should be considered preliminary, they are proving to be quite encouraging. The use of the tibial-tunnel method is still considered equally favorable. Only the careful, methodical collection of data from thoughtfully designed clinical studies will allow us to definitively determine the best course of treatment for the wide array of injuries seen in the wide spectrum of patients with PCL injuries. Verf.-Referat