A Study was conducted to evaluate the evidence for operative and non-operative management of isolated posterior cruciate ligament (PCL) injuries.
Quality assessment was performed with the Cochrane risk of bias tool (level I), the Newcastle–Ottowa Scale (level II–III) and the National Institute of Health quality assessment tool (level IV). Clinical outcome measures included residual laxity, return to sports, patient-reported outcome measures, subsequent articular degeneration and complications.
--27 studies including 5197 patients (5199 knees) with a mean age of 29.5?±?3.6 years fulfilled the study requirements.
--Significantly less residual laxity was found after posterior cruciate ligament reconstruction (PCLR) compared to non-operative management (3.43 vs. 5.47 mm).
--Both treatment modalities yielded satisfying functional outcomes and a high return to sports (64–77%).
--Osteoarthritis (OA) occurred less frequently following PCLR (21.5 vs. 44.1%).
In the absence of Level I RCTs, this comprehensive evaluation shows, in particular where the surgery is designed to minimize residual laxity and likely subsequent Arthritis, that surgical care for chosen isolated PCL injuries is an acceptable alternative.