Management of combined injuries of the posterior cruciate ligament and posterolateral corner of the knee: a systematic review

Abstract

Background: Approximately 60% of posterior cruciate ligament (PCL) injury are associated with a posterolateral corner (PLC) tear.

Sources of data: We performed a systematic review of the literature according to the PRISMA guidelines. The following key words were searched on Medline, Cochrane, EMBASE, Google Scholar, and Ovid: 'posterior cruciate ligament' or 'PCL' with 'posterolateral corner' or 'PLC' and 'chronic'; 'injury'; 'management'; 'reconstruction'; 'outcomes'; 'complications'.

Areas of agreement: There was a statistically significant improvement of all clinical scores after surgery regardless of the procedure performed to reconstruct both PCL and PLC.

Areas of controversy: No randomized control trials were identified on the topic. Standardized methods of functional outcomes assessment are necessary to improve communication on the functional results of the management of PC-PLC.

Growing points: Single stage surgical reconstruction of PCL and PLC is recommended in patients with posterolateral rotatory instability of the knee.

Areas timely for developing research: Adequately powered randomized trials with appropriate subjective and objective outcome measures are necessary to reach definitive conclusions.

Keywords: complications; knee; outcomes; posterior cruciate ligament; posterolateral corner; surgery.