Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jun;11(2):320-324.
doi: 10.1007/s12178-018-9493-0.

Revision PCL Reconstruction Review/Update

G Keith Gill  1 , F Winston Gwathmey  2
Affiliations
Review

Revision PCL Reconstruction Review/Update

G Keith Gill et al. Curr Rev Musculoskelet Med. 2018 Jun.

Abstract

Purpose of review: The primary goal of this review is to update recent literature on revision PCL reconstruction and to discuss factors relevant to surgical failure, surgical indications and goals, patient evaluation, surgical decision-making, graft selection, surgical technique, associated surgical procedures, postoperative rehabilitation, and revision PCL reconstruction results.

Recent findings: Specifically, it is paramount to consider and treat posteromedial and posterolateral instability. Success in revision surgery focuses on appropriate graft choice and precise tunnel placement at anatomical attachment sites. Furthermore, correct tensioning of the graft, secondary or backup fixation and well-designed PT and rehab protocols are integral components. The factors causing failure of the primary reconstruction should be identified, as revision surgery must address the errors and follow strict surgical principals to be successful. There are many variables that play a role in successful revision posterior cruciate ligament (PCL) reconstruction. In general, as in most ligament reconstruction surgery, it is important to identify and address all associated pathology such as lower extremity malalignment and additional instability.

Keywords: Graft; PCL; Revision.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

Both authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Grade 3 posterior drawer indicative of PCL and PLC injury
Fig. 2
Fig. 2
Revision PCL reconstruction with femoral tunnel drilling after allograft bone dowel placement. The dowel (purple) is used to graft the defect and the new tunnel will be drilled adjacent over the guide wire
Fig. 3
Fig. 3
Arthroscopic image of outside-in PCL femoral tunnel drilling with the superior guide pin marking the single-bundle PCL footprint and the inferior guide pin for the ACL coming in from the accessory anteromedial portal
See this image and copyright information in PMC

References

    1. Strobel MJ, Weiler A, Schulz MS, Russe K, Jürgen Eichhorn H. Arthroscopic evaluation of articular cartilage lesions in posterior cruciate ligament—deficient knees. Arthroscopy. 2003;19(3):262–268. doi: 10.1053/jars.2003.50037. - DOI - PubMed
    1. Ao Y, Cheng X, Hu Y, Cui G, Yu J. Clinical research for reason analysis of posterior cruciate ligament reconstruction revision. Zhonghua Wai Ke Za Zhi. 2009;47(7):541–544. - PubMed
    1. Tischer T, et al. The impact of osseous malalignment and realignment procedures in knee ligament surgery: a systematic review of the clinical evidence. Orthop J Sports Med. 2017;5(3):2325967117697287. doi: 10.1177/2325967117697287. - DOI - PMC - PubMed
    1. Li J, Kong F, Gao X, Shen Y, Gao S. Prospective randomized comparison of knee stability and proprioception for posterior cruciate ligament reconstruction with autograft, hybrid graft, and γ-irradiated allograft. Arthroscopy. 2016;32(12):2548–2555. doi: 10.1016/j.arthro.2016.04.024. - DOI - PubMed
    1. Werner BC, Gilmore CJ, Hamann JC, Gaskin CM, Carroll JJ, Hart JM, Miller MD. Revision anterior cruciate ligament reconstruction: results of a single-stage approach using allograft dowel bone grafting for femoral defects. J Am Acad Orthop Surg. 2016;24(8):581–587. doi: 10.5435/JAAOS-D-15-00572. - DOI - PubMed

LinkOut - more resources