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

Abstract

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.