Selected Case Studies in Posterior Cruciate Ligament Reconstruction

This chapter presents selected cases in treatment of the posterior cruciate ligament (PCL)-injured knee that are representative of my practice. I have written this chapter in the first person to provide a more personal approach to presenting these topics. These selected cases represent real-life management examples in the treatment of difficult knee ligament instability problems. The format followed will be the same for each case study to provide consistency in the presentation, and is outlined as follows: history, physical examination, imaging study findings, surgical timing, graft selection, surgical technique (when applicable), postoperative rehabilitation program, and results. Details of the surgical technique will not be presented in this chapter since the surgical technique was performed as I have described in Chaps. 1, 9, 15, 19, and 21. Specific topics presented in this chapter of selected case studies of PCL reconstruction include nonsurgical treatment, open growth plates, multiple ligament knee injuries in young athletes and middle-aged adults, 15-year postoperative outcomes, extensor mechanism disruption, complex knee ligament instability in the obese patient, revision PCL surgery, and peroneal nerve injury. The purpose of this case study section is for the reader to gain insight into management and treatment strategy decisions in these complex knee ligament injuries.