Global variation in isolated posterior cruciate ligament reconstruction
Abstract Purpose In the setting of persistent instability or failed non‐operative management, surgical reconstruction is commonly recommended for isolated posterior cruciate ligament (PCL) tears. The purpose of this study was to systematically review published studies to evaluate regional variation...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-022-00541-4 |
| _version_ | 1797321470027759616 |
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| author | Derrick M. Knapik Varun Gopinatth Garrett R. Jackson Jorge Chahla Matthew V. Smith Matthew J. Matava Robert H. Brophy |
| author_facet | Derrick M. Knapik Varun Gopinatth Garrett R. Jackson Jorge Chahla Matthew V. Smith Matthew J. Matava Robert H. Brophy |
| author_sort | Derrick M. Knapik |
| collection | DOAJ |
| description | Abstract Purpose In the setting of persistent instability or failed non‐operative management, surgical reconstruction is commonly recommended for isolated posterior cruciate ligament (PCL) tears. The purpose of this study was to systematically review published studies to evaluate regional variation in the epidemiology of and surgical approaches to primary, isolated PCL reconstruction. Methods A systematic review was performed in June 2022 to identify studies examining operative techniques during primary, isolated PCL reconstruction. Collected variables consisted of reconstruction technique, graft type, graft source, tibial reconstruction technique, femoral and tibial drilling and fixation methods, and whether the remnant PCL was preserved or debrided. Studies were classified into four global regions: Asia, Europe, North America, and South America. Results Forty‐five studies, consisting of 1461 total patients, were identified. Most of the included studies were from Asia (69%, n = 31/45). Single bundle reconstruction was more commonly reported in studies out of Asia, Europe, and North America. Hamstring autografts were utilized in 51.7% (n = 611/1181) of patients from Asia and 60.8% (n = 124/204) of patients from Europe. Trans‐tibial drilling and outside‐in femoral drilling were commonly reported in all global regions. The PCL remnant was generally debrided, while remnant preservation was commonly reported in studies from Asia. Conclusion Surgical treatment of isolated PCL injuries varies by region, with the majority of published studies coming from Asia. Single‐bundle reconstruction with hamstring autograft through a trans‐tibial approach is the most commonly reported technique in the literature, with males reported to undergo isolated reconstruction more often than females. Level of Evidence Systematic review, Level IV. |
| first_indexed | 2024-03-08T04:58:02Z |
| format | Article |
| id | doaj.art-0042be121e3741e2b778e6597d7b4e6d |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T04:58:02Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-0042be121e3741e2b778e6597d7b4e6d2024-02-07T14:50:37ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00541-4Global variation in isolated posterior cruciate ligament reconstructionDerrick M. Knapik0Varun Gopinatth1Garrett R. Jackson2Jorge Chahla3Matthew V. Smith4Matthew J. Matava5Robert H. Brophy6Department of Orthopaedic SurgeryDivision of Sports MedicineWashington University in St. LouisSt. LouisMOUSASaint Louis UniversitySchool of MedicineSt. LouisMOUSAMidwest Orthopaedics at Rush UniversityChicagoILUSAMidwest Orthopaedics at Rush UniversityChicagoILUSADepartment of Orthopaedic SurgeryDivision of Sports MedicineWashington University in St. LouisSt. LouisMOUSADepartment of Orthopaedic SurgeryDivision of Sports MedicineWashington University in St. LouisSt. LouisMOUSADepartment of Orthopaedic SurgeryDivision of Sports MedicineWashington University in St. LouisSt. LouisMOUSAAbstract Purpose In the setting of persistent instability or failed non‐operative management, surgical reconstruction is commonly recommended for isolated posterior cruciate ligament (PCL) tears. The purpose of this study was to systematically review published studies to evaluate regional variation in the epidemiology of and surgical approaches to primary, isolated PCL reconstruction. Methods A systematic review was performed in June 2022 to identify studies examining operative techniques during primary, isolated PCL reconstruction. Collected variables consisted of reconstruction technique, graft type, graft source, tibial reconstruction technique, femoral and tibial drilling and fixation methods, and whether the remnant PCL was preserved or debrided. Studies were classified into four global regions: Asia, Europe, North America, and South America. Results Forty‐five studies, consisting of 1461 total patients, were identified. Most of the included studies were from Asia (69%, n = 31/45). Single bundle reconstruction was more commonly reported in studies out of Asia, Europe, and North America. Hamstring autografts were utilized in 51.7% (n = 611/1181) of patients from Asia and 60.8% (n = 124/204) of patients from Europe. Trans‐tibial drilling and outside‐in femoral drilling were commonly reported in all global regions. The PCL remnant was generally debrided, while remnant preservation was commonly reported in studies from Asia. Conclusion Surgical treatment of isolated PCL injuries varies by region, with the majority of published studies coming from Asia. Single‐bundle reconstruction with hamstring autograft through a trans‐tibial approach is the most commonly reported technique in the literature, with males reported to undergo isolated reconstruction more often than females. Level of Evidence Systematic review, Level IV.https://doi.org/10.1186/s40634-022-00541-4Posterior cruciate ligamentReconstructionKneeRegional variation |
| spellingShingle | Derrick M. Knapik Varun Gopinatth Garrett R. Jackson Jorge Chahla Matthew V. Smith Matthew J. Matava Robert H. Brophy Global variation in isolated posterior cruciate ligament reconstruction Journal of Experimental Orthopaedics Posterior cruciate ligament Reconstruction Knee Regional variation |
| title | Global variation in isolated posterior cruciate ligament reconstruction |
| title_full | Global variation in isolated posterior cruciate ligament reconstruction |
| title_fullStr | Global variation in isolated posterior cruciate ligament reconstruction |
| title_full_unstemmed | Global variation in isolated posterior cruciate ligament reconstruction |
| title_short | Global variation in isolated posterior cruciate ligament reconstruction |
| title_sort | global variation in isolated posterior cruciate ligament reconstruction |
| topic | Posterior cruciate ligament Reconstruction Knee Regional variation |
| url | https://doi.org/10.1186/s40634-022-00541-4 |
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