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. 2025 Jun 1;111(6):4080-4085.
doi: 10.1097/JS9.0000000000002416. Epub 2025 Apr 25.

Management of posterior cruciate ligament injuries: an expert consensus from 17 countries

Shuguang Gao  1   2   3   4 , Jiahao Meng  1 , Chao Zeng  1   2   3   4 , Joan C Monllau  5 , Robert F LaPrade  6 , Timothy N Taft  7 , Jeffrey H Berg  8 , Michael J Medvecky  9 , Kevin R Stone  10 , Michael J Scarcella  11 , Frank A Cordasco  12 , Brian R Wolf  13 , Dustin L Richter  14 , Scott A Rodeo  15 , Timothy E Hewett  16 , Bruce A Levy  17 , James Lee Pace  18 , Bobby Anand  19 , Filippo Picinini  20 , Riccardo D'Ambrosi  21   22 , Luca Maria Sconfienza  21   22 , Luca Farinelli  23 , Bancha Chernchujit  24 , Anders Stålman  25   26 , Amit Gilad  27 , Srinivas B S Kambhampati  28 , Silvampatti Ramasamy Sundararajan  29 , Abayo Remy Patrick  30 , Juvenal Nshimirimana  31 , Pisit Lertwanich  32 , Michael Opoku  33 , Thana Buranapuntaruk  34 , Leonardo Addeo Ramos  35 , Hoi Po James Hui  36 , Terence D'Souza  37 , Alberto Grassi  38 , Mohammad Razi  39 , Jaime Mariño  40 , Manuel Mosquera  41 , Johannes Barth  42 , Dinshaw N Pardiwala  43 , Yusheng Li  1 , Wenfeng Xiao  1 , Yilin Xiong  1 , Pan Liu  1 , Liu Yang  44 , Panghu Zhou  45 , Yan Xu  46 , Xizhuang Bai  47 , Tengbo Yu  48 , Chunbao Li  49 , Licheng Wei  50 , Liangjun Li  51 , Juan Wang  52 , Decheng Shao  53 , Zhenpeng Guan  54 , Xuesong Dai  55 , Jingmin Huang  56 , Jian Li  57 , Weiping Li  58 , Guangji Wang  59 , Bing Yue  60 , Zhizeng Gao  61 , Lin Guo  62 , Yinghui Hua  63 , Meng Wu  64 , Jing Wang  65 , Xiaofei Zheng  66 , Lunhao Bai  67 , Jiwu Chen  68 , Weihong Zhu  69 , Qichun Zhao  70 , Weiguo Zhang  71 , Zhiwei Chen  72 , Xiaochun Wei  73 , Wei Lu  74 , Ziquan Yang  75 , Qingjun Wei  76 , Liaobin Chen  77 , Songcen Lv  78 , Ning Liu  79 , Yongsheng Xu  80 , Yanlin Li  81 , Xuesong Wang  82 , Hui Zhang  82 , Weidong Xu  83 , Qing Jiang  84 , Tianlong Huang  69 , Jiakuo Yu  85 , Jiang Zheng  86 , Keyuan Zhang  87 , Jianquan Wang  46 , Guanghua Lei  1   2   3   4
Affiliations

Management of posterior cruciate ligament injuries: an expert consensus from 17 countries

Shuguang Gao et al. Int J Surg. .

Abstract

Background: Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries.

Objectives: To use the modified Delphi method to reach expert consensus on the management of PCL injury.

Methods: A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement).

Results: The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations.

Conclusion: Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries.

Keywords: consensus; diagnosis; posterior cruciate ligament; treatment.

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Conflict of interest statement

There were no conflicts of interest.

Figures

Figure 1.
Figure 1.
MRI of normal, partial tear, femoral insertion avulsion, and total tear of posterior cruciate ligament. A normal posterior cruciate ligament (PCL) is shown in a sagittal image in Panel A (white arrow) and a coronal image in Panel B (white arrow). A partial tear of PCL is shown in Panel C (white arrow) and Panel D (white arrow). A femoral insertion avulsion of PCL is shown in Panel E (white arrow) and Panel F (white arrow). A total tear of PCL is shown in Panel G (black arrow) and Panel H (black arrow).
Figure 2.
Figure 2.
Algorithm for the management of posterior cruciate ligament injuries.
See this image and copyright information in PMC

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