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Primary Posterior Cruciate Ligament Repair With The Novel Suture Tape Augmentation Technique.

BACKGROUND
A posterior cruciate ligament (PCL) rupture is less common than an anterior cruciate ligament (ACL) rupture. PCL reconstruction remains controversial with variable outcomes and problems. The encouraging results of the novel ACL repair techniques led to renewed interest in PCL repair. Primary arthroscopic PCL repair has been rarely discussed and literature is scarce. To the best of our knowledge, no PCL repair patient outcome has been reported with one of the novel PCL repair techniques. We present the first case report of two patients who have been treated with the novel PCL repair technique, the suture tape augmentation technique.


CASE DESCRIPTION
Two patients who underwent primary PCL repair after an acute PCL rupture with a two-year follow up are presented. Patients were evaluated according to the Lysholm scale, the International Knee Documentation Committee (IKDC), and the Tegner activity scale. Follow up also included objective physical examinations-knee function and posterior drawer test using a rolimeter-and magnetic resonance imaging (MRI). Physical examinations were performed at three months, six months, one year, and two years after surgery.


OUTCOMES
At two-year follow up, both patients had a full range of motion and experienced no pain, nor swelling. IKDC scores were 83% (good) and 100% (excellent), Lysholm scores were 99 and 100 two years after surgery. At three months postoperative, the Tegner activity scale equaled the preinjury Tegner activity scale. One patient was horseback riding within three months. There were some increased posterior translation differences after two years-+2 and +3mm-compared with six weeks postoperative. MRI showed a healed PCL in both cases.


DISCUSSION
PCL repair could be a promising treatment option for acute PCL ruptures. Advantages of this technique are the retaining of the natural proprioceptive capacities due to preserving native PCL fibers, the surgical technique is less invasive compared to a reconstruction, and no donor graft morbidity is expected as no graft is needed.


CONCLUSION
In these two cases, good subjective and objective results are demonstrated after PCL repair using the novel suture tape augmentation technique. MRI confirmed the healing of the PCL. Although this is a small case series, as PCL ruptures are less common compared to ACL ruptures, it is a stepping-stone for further PCL repair research.