Does surgical reconstruction produce better stability than conservative treatment in the isolated PCL injuries?

Abstract

Introduction: The purpose of this study was to conduct a systematic review to address the stability outcome from reconstruction and conservative treatments.

Materials and methods: Inclusion criteria were as follows: (1) English language, (2) human subject, (3) measures of stability outcomes, and (4) patients with isolated PCL injuries. We did not limit the type of study design (interventional or non-interventional study) and included all published systematic reviews. The following data were extracted: the number of study populations, year of publication, baseline characteristics of patients, follow-up period, and outcome data. The primary outcome variable was side-to-side difference (STSD).

Results: In the conservative treatment, the average STSD ranged from 3.5 to 5.3 mm on Telos™ (range 0.7-12.0 mm) and from 3.0 to 5.2 mm on KT-1000™ (range 0.5-10 mm). Among reconstructive treatment, the average STSD ranged from 2.0 to 3.7 mm on Telos™ (range 0-7 mm) and 0.7-5.9 mm on KT-1000™ (range -1 to 11.8 mm). In the conservative treatment, the estimated weighted mean STSD difference was 3.49 [95 % confidence interval (CI): 0.95-6.03] on Telos™ and 2.64 (95 % CI 0.76-4.51) on KT-1000™. On the other hand, in the reconstructive treatment, the estimated mean STSD difference was 8.09 (95 % CI 7.11-9.07) on Telos™ and 8.45 (95 % CI 6.44-10.47) on KT-1000™.

Conclusions: This systematic review noted more satisfactory and consistent stability in the reconstructive treatment group. However, more complications and small differences of stability between groups should be also considered.

Keywords: Conservative treatment; Knee; Posterior cruciate ligament; Reconstruction.