Kwiecinski, Hannah
(2024)
Isolated Posterior Cruciate Ligament Injury: Outcomes and Complications of Operative and Nonoperative Treatment.
Master Essay, University of Pittsburgh.
Abstract
Background: Isolated posterior cruciate ligament (PCL) injury has been associated with long lasting symptoms such as knee laxity and knee osteoarthritis. While conservative treatment is often indicated, there is no current standard of care for isolated PCL injury. Both operative and nonoperative treatments aim to restore native knee kinematics; no methods have yielded such results. Long-term outcomes of this injury have seldom been explored. The primary objective of this literature review is to report long-term outcomes and complications of isolated PCL injury following either operative or nonoperative treatment.
Methods: With the help of a health sciences librarian, a literature search was completed in Medline. Multiple rounds of screening were performed to target long-term outcomes of isolated PCL injury reported with a minimum of 5 years of follow-up. This search yielded n=7 articles for final review.
Results: Of the seven identified articles, the majority were prospective cohort studies. These articles mainly explored operative treatments for isolated PCL injury. One article reviewed nonoperative treatments, and one article compared operative and nonoperative methods. The following outcomes were commonly reported: Lysholm Knee Scoring Scale, Tenger activity score, International Knee Documentation Committee (IKDC) knee score, various forms of radiographic assessment outcomes, knee OA, range of motion (ROM), secondary meniscal tears, total knee arthroplasty (TKA), side-to-side differences (STSDs) and joint laxity, and subjective patient-reported symptoms. Across all studies, physical symptoms improved following treatment regardless of method used.
Discussion: Standards of care must be implemented to best reduce the incidence of poor outcomes following isolated PCL injury. Little is known regarding the epidemiology of isolated PCL injury, so future research must include methods to gather incidence-, prevalence-, and severity-related information. Current literature explores the immediate efficacy of various surgical techniques, but further emphasis must be placed on the restoration of knee kinematics. Operative treatment may be a protective measure against degenerative outcomes such as knee osteoarthritis, but high-quality evidence is currently lacking in the assessment of this relationship. Isolated PCL injury presents as a continued public health concern, as those who experience this injury are often left with lasting symptoms such as chronic pain and instability.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Thesis advisor | Songer, Thomas | tjs@pitt.edu | tjs | UNSPECIFIED | | Committee Member | Buchanich, Jeanine | jeanine@pitt.edu | jeanine | UNSPECIFIED | | Committee Member | Welburn, Sharon | scw86@pitt.edu | scw86 | UNSPECIFIED |
|
| Date: |
3 January 2024 |
| Date Type: |
Completion |
| Submission Date: |
14 December 2023 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
61 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
posterior cruciate ligament injury; PCL injury; injury outcomes and complications; knee osteoarthritis; posterior cruciate ligament reconstruction |
| Date Deposited: |
03 Jan 2024 17:00 |
| Last Modified: |
03 Jan 2024 17:00 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/45693 |
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