Highlights
- •Neglected PCL bony avulsion injuries are rare.
- •The challenge with neglected cases is that the PCL is retracted and fibrosed.
- •Intra-articular release of the contracted ligament, burr hole drilling of the fracture bed, combined with the screw post fixation technique can achieve good results.
Abstract
Background
Contrary to acute posterior cruciate ligament (PCL) bony tibial avulsions, surgical
management of chronic injuries is technically challenging and appears to be controversial.
We sought to assess the outcome of a novel screw post augmentation technique in neglected
cases.
Methods
16 patients were followed up in a tertiary single-center retrospective study. The
bony fragment was fixed using a lag screw with a spiked washer and an additional screw
post through an open posterior approach. The pre- and postoperative knee range of
movement (ROM), laxity, and modified Tegner–Lysholm (TL) scores were compared.
Results
The median time from injury to surgery was 10 weeks (range, 3–260). The mean clinical
follow-up time was 24.25 ± 9.21 months. At the final follow-up, the mean knee ROM
flexion was 130° ± 11.55° with no extension lag. 3 patients had grade 1 laxity. The
TL grade was predominantly excellent, and the overall median score improved from 76
preoperatively to 95 postoperatively (p < 0.0004). Bony union was achieved in all cases.
Conclusion
The described screw post fixation technique results in an excellent outcome for these
rare injuries.
Level of evidence
Level IV, case series.
Keywords
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Article info
Publication history
Published online: February 01, 2019
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