Abstract

RODRIGUES, Joana Bento  and  FONSECA, Fernando. Rotura isolada do ligamento cruzado posterior: História Natural, Tratamento e Reabilitação. Rev. Port. Ortop. Traum. [online]. 2012, vol.20, n.2, pp.181-196. ISSN 1646-2122.

Introduction: The natural history of isolated posterior cruciate ligament (PCL) injuries is not determined. Indications for conservative or surgical treatment remain unclear and several options and techniques are available. Objetives: To better understand the natural history of isolated PCL injuries and assess the current recommendations with regard to treatment and rehabilitation. Sources: Search (in September 2011) in PubMed/Medline, using "posterior cruciate ligament" - resulting in 3,149 articles - and available literature consult. The title, abstract or all article relevance were considered in the selection. Data Synthesis: The final paper comprises 88 references, including 3 textbooks, a controlled study, 30 publications of the last 10 years (about 77%), 3 studies with evidence levels between 1b and 3. Conclusions: The prognosis of isolated PCL injuries varies. There is a tendency to degenerative joint disease and functional deterioration. However, for their regenerative potential, a second evaluation is recommended at six months after injury. Conservative treatment is indicated in grade 1 or 2 instabilities, remaining uncertain in athletes. Surgery is reserved to multiple ligament injuries or isolated grade 3 instabilities. Good results were achieved with hamstring tendon grafts or quadriceps tendon, as well as tibial inlay technique. Advantages in the use of double-bundle grafts remain unclear, contrasting to single-bundle. Synthetic and transplanted PCL are currently under study and the preservation of remaining fibers, tibial osteotomy or administration of inhibitors of nitric oxide were also suggested.

Keywords : Posterior cruciate ligament; treatment; evolution.

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