Management of Posterior Cruciate Ligament Injury: A Concise Overview of Current Indications, Techniques, and Outcomes.

J Am Acad Orthop Surg · Oct 31 2025 · Review

Knapik DM, Smith MV, Matava MJ, Brophy RH

From the All authors are affiliated with the Department of Orthopedic Surgery, Washington University School of…

Sports Medicine Pediatric Orthopaedics

SUMMARY — THE REDUCTIONThis review summarizes current controversies in PCL injury management, including repair versus reconstruction, graft and fixation choices, and factors like posterior tibial slope affecting outcomes.
Abstract, as published

The posterior cruciate ligament (PCL) is crucial for normal knee kinematics and stability. An improved understanding of the long-term consequences of PCL injuries has led to greater focus on accurate injury diagnosis and improvements in surgical instrumentation and techniques. However, controversy remains regarding indications for surgical versus nonsurgical management, as well as optimal surgical techniques such as PCL repair versus reconstruction, single-bundle versus double-bundle reconstruction, transtibial versus tibial inlay fixation, and graft choice. Recognition of concomitant injuries and posterior tibial slope, as well as considerations in pediatric patients, warrants additional attention to ensure satisfactory outcomes. The purpose of this review was to evaluate the current state of the literature on PCL injuries and variables associated with injury decision making based on reported outcomes.

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