J Knee Surg
DOI: 10.1055/a-2542-2417
Original Article

Posterior cruciate ligament revision surgery: Outcomes, failure rates, and complications. A systematic review of the literature

1   C.A.S.C.O., IRCCS Istituto Ortopedico Galeazzi, Milano, Italy (Ringgold ID: RIN46767)
,
Alessandro Carrozzo
2   Italian Olympic Committee, Institute for Sports Medicine, Rome, Italy
,
Fabrizio Di Feo
3   CASCO Department, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy (Ringgold ID: RIN46767)
,
Edna Skopljak
4   Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia (Ringgold ID: RIN37667)
,
Srinivas BS Kambhampati
5   Orthopedic Department, Sri Dhaatri Orthopaedic, Maternity & Gynaecology Center, Andra Pradesh, India
,
Manish Attri
6   Central Institute of Orthopedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India (Ringgold ID: RIN78595)
,
Amit Meena
7   Department of Orthopaedics, Shalby Hospitals, Jaipur, India (Ringgold ID: RIN80002)
› Author Affiliations

Purpose: To synthesise and qualitatively assess the currently available evidence in the literature regarding the revision of posterior cruciate ligament (PCL) reconstruction. Methods: A systematic review was conducted on the basis of the PRISMA guidelines. The outcome data extracted from the studies were the Lysholm score, Orthopadische Arbeitsgruppe Knie (OAK) scoring system, KT-2000, International Knee Documentation Committee (IKDC) subjective and objective, radiological changes, rate of return to sports, complications, and failures and/or revision surgeries. Results: The cohort consisted of 54 patients (42 [77.8%] men and 12 [22.2%] women), with a mean age of 33.14 ±3.67 years (range 17–48 years). The mean postoperative follow-up was 71.8 ±45.32 months, whereas the mean time from primary surgery to revision was 41.7 ±4.5 months. All studies reported a clinical improvement from preoperative to final follow-up in terms of the Lysholm, OAK, KT-2000, and IKDC scores (p<0.05). Posterior displacement was significantly improved in all studies, demonstrating the stability of the knee. The mean posterior displacement ranged from a preoperative value of 10.68 ±0.7 mm to a final value of 2.7 ±0.2 mm (p<0.05). A total of two (3.7%) failures were reported, and there were also eight (14.8%) revision surgeries. Conclusions: Studies on posterior cruciate ligament reconstruction revisions have shown satisfactory clinical outcomes and a high level of knee stability, with a minimal risk of new reruptures. However, the rate of returning to preinjury sports activity is relatively low. Whenever possibile, it is recommended to perform the ligament revision in a single stage.



Publication History

Received: 16 December 2024

Accepted after revision: 18 February 2025

Accepted Manuscript online:
20 February 2025

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