Purpose
The purpose of this study was to confirm the contribution of long leg cast immobilization
to posterior stability after reconstruction of isolated posterior cruciate ligament
(PCL) injuries.
Methods
Of 84 patients who underwent arthroscopic PCL reconstruction between November 2006
and December 2009, 44 patients were randomly assigned to 2 groups and analyzed prospectively.
For 22 patients (the cast group), long leg cast immobilization was applied until postoperative
week 5 and then a 0° locking brace was worn until week 12. Full weight bearing was
allowed immediately after operation. For the other 22 patients (the brace group),
only a 0° locking brace was applied until postoperative week 12 without cast immobilization.
Range of motion (ROM), clinical scores, Telos device (Telos, Marburg, Germany) posterior
stress radiographic assessment results and International Knee Documentation Committee
(IKDC) grades of both groups were analyzed preoperatively and at postoperative years
1 and 2.
Results
The mean preoperative side-to-side difference on Telos posterior stress radiographs
was 11.3 ± 2.5 mm in the cast group and 12.7 ± 2.1 mm in the brace group, revealing
no differences between the 2 groups (P = .743), but postoperatively the mean difference measured 2.5 ± 1.9 mm and 4.8 ±
2.4 mm, respectively, showing a significantly smaller difference in the cast group
(P = .004); the improvement was 8.8 mm and 7.9 mm, respectively, and was statistically
significant (P = .021). Preoperative IKDC grades were not different between the 2 groups (P > .05), but 2 years postoperatively, the cast group showed a significantly better
distribution of grades (P = .012). The mean ROM, Lysholm scores, IKDC subjective scores, and Tegner scores
2 years postoperatively were not significantly different between the 2 groups (P > .05).
Conclusions
The patients immobilized with long leg casts until 5 weeks after PCL reconstruction
showed significantly better results in Telos posterior stress radiographs and distribution
of IKDC grades 2 years postoperatively and did not show limited ROM when compared
with the patients who wore braces only. However, IKDC subjective scores were not found
to be different between the 2 groups.
Level of Evidence
Level I, prospective randomized comparative study.
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Article info
Publication history
Published online: January 25, 2013
Accepted:
October 16,
2012
Received:
March 31,
2012
Footnotes
Supported by a research grant from Smith & Nephew, Andover, MA.
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
