Annals of Applied Sport Science

Background. PCL reconstruction is a successful method for enhancing the patient's quality of life but posterior knee laxity and knee stiffness have still occurred surgery. There is no study to evaluate knee laxity or loss of knee range of motion after surgery.
Objectives. To assess the outcomes after PCL reconstruction, we: 1) evaluated the range of motion of the knee, 2) evaluated posterior knee laxity, and 3) determined the factors that influence laxity or the loss of range of motion after surgery.
Methods. Articles that met the following criteria were enrolled in this review: 1) articles on peer-reviewed level 1 to 4 studies; 2) articles published in English; 3) articles on PCL reconstruction studies; 4) articles on isolated PCL rupture; 5) articles that describe laxity after surgery and 6) articles that describe the degree of range of motion after surgery.
Results. Involving a total of 1711 patients. There was a loss of extension and flexion after PCL reconstruction (9.15% and 28.9%, respectively). Knee laxity was still observed at the final examination in the posterior drawer test, KT 1000/2000 test, and Telos radiographic view (64.8%, 42.8%, and 47.9%, respectively). In the subgroup analysis, there was no significant difference in laxity between allograft group vs autograft group using the KT 1000/2000 measurement (mean difference [MD] = -0.42, 95% confidence interval [-1.41, 0.56], p = 0.40), Single Bundle vs Double Bundle (DB) using the KT 1000/2000 measurement (MD = -0.003, 95% CI [-1.35, 1.29], p < 0.00001), and transtibial vs tibial inlay using the Telos radiograph measurement (MD = 0.03, 95% CI [-0.33, 0.39], p = 0.88), but DB significantly improved knee stability using the Telos radiographic measurement (MD = 0.69, 95% CI [0.29,1.09], p = 0.00008).
Conclusion. This study demonstrates that the loss of range of motion or laxity is still a problem after PCL reconstruction.

Background. Remnant preservation was developed as a routine procedure for posterior cruciate ligament (PCL) reconstruction, but it is not easy.
Objectives. Our study aimed to evaluate the outcomes of a minimum 5-years follow-up of remnant preservation PCL reconstruction.
Methods. The study was a prospective cohort analysis of 44 patients who underwent PCL reconstruction with remnant preservation and a minimum 5-years follow-up. Outcome parameters included were modified Cincinnati score, Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, degree of laxity (Posterior Drawer Test), single-leg hop test, and knee x-ray findings.
Results. The mean diameter of the hamstring autograft was 8 ± 2.04 mm. The mean of Lysholm knee scores increased from 65.15 ± 10.48 to 86.94 ± 4.80. The IKDC subjective score increased from 62.55 ± 18.10 (range, 40–65) to 88.65 ± 3.44 (range, 65–100) points, and the Modified Cincinnati Score from 63.32 ± 13.65 to 86.24 ± 1.64. For Posterior Drawer Test results after surgery, 37 patients (84%) had grade 1, 5 (11%) had grade 2, and 2 (4.5%) had grade 3 of laxity. For the range of motion measurements, 39 (88.6%) patients had normal knee status, 3 (6.8%) presented with flexion deficit >25o, and 1 (2.2%) had a 16o-25o deficit in flexion, and 1 (2.2%) had a 16o-25o deficit in extension. Eight cases had the infection at the local incision site, which was resolved with conservative treatment.
Conclusion. Remnant preservation in PCL reconstruction with standard and posteromedial portal at a minimum 5-year assessment showed satisfactory clinical, functional outcome, and radiological evaluation outcomes.