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Primary Repair for Posterior Cruciate Ligament Injuries

An Eight-Year Followup of Fifty-three Patients

Department of Trauma Surgery, University of Ulm, Ulm, Germany

Hartmuth Kiefer, MD

Department of Trauma Surgery, University of Ulm, Ulm, Germany

Gerhard Hehl, MD

Department of Trauma Surgery, University of Ulm, Ulm, Germany

Lothar Kinzl, MD

Department of Trauma Surgery, University of Ulm, Ulm, Germany

We reviewed 53 of 58 patients who had primary repairs of posterior cruciate ligament injuries between 1981 and 1988. Sixteen patients had isolated posterior cru ciate ligament ruptures, 16 had complex injuries with capsular and collateral ligament involvement, and 21 had additional anterior cruciate ligament ruptures. For ty-six patients were treated by transosseous multiple- loop sutures and seven with bony avulsions by screw osteosynthesis. The mean follow-up time was 7.5 years (range, 3 to 12). All patients were examined subjectively (questionnaire) and objectively (clinical ex amination, KT-1000 arthrometer, functional testing, ra diographs, and Cybex II isokinetic strength analysis). The results were graded according to the International Knee Documentation Committee evaluation form and the Lysholm score. The average Lysholm score was 82.4 (range, 40 to 100). Thirty-eight patients returned to their preinjury activities at the same intensity level. The patients' subjective assessments were normal or nearly normal in 35 patients. The posterior drawer test was negative or 1 + in 46 patients. Cybex isokinetic strength analysis revealed a decrease in quadriceps muscle strength of the involved limb by 10.5% (P < 0.01). Our data suggest that primary repair of posterior cruciate ligament ruptures provides good results after 8 years in approximately two thirds of the patients. Distal ligamentous ruptures, lack of athletic activity, and tem porary olecranization correlated with poor results. Bony avulsions, midsubstance or proximal ruptures, and athletic activity correlated with good results.

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