Replacing or reconstructing the Posterior Cruciate Ligament (PCL) has not been an operation favoured by surgeons worldwide.
If the PCL is the only ligament in the knee that is damaged, dependant on the extent of the damage and the requirements of the patient, it is quite often the case that they can cope without the need for surgery.
In addition, many surgeons will only attempt an operation on the PCL if a knee had suffered multi ligament damage.
As a result of the PCL being located at the back of the knee it is difficult to access and work on, and repair is generally a complicated procedure. The surgery can take up to four hours. Many patients go on to have significant “laxity” or exceeive movement. Unlike the more straight forward ACL surgery where we get to within 1-2mm of abnormal movement following surgery, at 3 months a “good result’ following the more complex PCL reonstruction is when the excessive movement is 50% less than the starting point.
This high failure rate is the consequence of the PCL being constantly subject to the weight of the tibia or shin bone … resulting in the grafts stretching which create excessive backward and forward movement in the joint.
At Hampshire Knee we have analysed the cause of these problems and have developed a procedure using the “all inside” operating technique along with artificial ligament support.
By using a small loop of polyester tape as an internal brace to support the ligament we are able to help and enhance the biological healing process, and at the same time prevent the PCL becoming slack and failing in the way of the traditional approach.
The result is a faster more successful operation, which not only reduces stretching and laxity in the joint but is also less invasive in terms of bone and soft tissue damage.
As with other procedures employing All Inside and Artificial Ligament reinforcement surgery we are experiencing much improved recovery times and significantly higher success rates.