Injuries to the posterior cruciate ligament and posterolateral structures of the knee

Although the incidence of injuries to the posterior cruciate ligament (PCL) is much lower than with the anterior cruciate, recent evidence suggests that deficiency of the PCL may be a much larger problem than originally thought, in the isolated case or in combination with posterolateral structures. Although advances have been made in understanding PCL injuries, the diagnosis and treatment of PCL insufficiency remain unclear. The natural history of a PCL-deficient knee is just beginning to be understood. Numerous methods have been reported for the surgical repair and reconstruction of the PCL, yielding less than optimal results in many cases. Controversy exists regarding the choice between conservative and surgical treatment in the isolated PCL injury. This article reviews the literature and summarizes the state of the art regarding the PCL and related posterolateral injuries, with an emphasis on anatomy, biomechanics, mechanism of injury, diagnosis and treatment Future directions in PCL research are proposed.