Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries

<b>Background:</b> Posterior cruciate ligament (PCL) injuries are relatively rare, with limited consensus on the optimal treatment for isolated acute cases. Conservative management and surgical reconstruction each offer potential benefits, but their comparative efficacy remains unclear....

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Main Authors: Roberto Tedeschi, Federica Giorgi, Daniela Platano, Lisa Berti, Fabio Vita, Danilo Donati
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Surgeries
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Online Access:https://www.mdpi.com/2673-4095/6/1/24
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author Roberto Tedeschi
Federica Giorgi
Daniela Platano
Lisa Berti
Fabio Vita
Danilo Donati
author_facet Roberto Tedeschi
Federica Giorgi
Daniela Platano
Lisa Berti
Fabio Vita
Danilo Donati
author_sort Roberto Tedeschi
collection DOAJ
description <b>Background:</b> Posterior cruciate ligament (PCL) injuries are relatively rare, with limited consensus on the optimal treatment for isolated acute cases. Conservative management and surgical reconstruction each offer potential benefits, but their comparative efficacy remains unclear. <b>Methods:</b> A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search of MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science was completed on 23 December 2024. Studies comparing conservative treatment and surgical reconstruction for isolated acute PCL injuries were included. Outcomes such as functional recovery, stability, and long-term complications were extracted and synthesized qualitatively. <b>Results:</b> Six studies were included, comprising case series, prospective, retrospective, and review designs. Conservative treatment demonstrated significant improvements in functional recovery (IKDC scores: 67–90.3/100) but showed limited improvement in stability (STSD reduction: 0–3 mm). Surgical reconstruction yielded superior stability (STSD reduction: 8.2 to 2.7 mm) and lower rates of degenerative changes but was associated with a higher risk of complications. Functional outcomes were comparable between approaches in some studies, although surgical patients showed slightly better long-term stability. <b>Conclusions:</b> Both conservative and surgical treatments achieve satisfactory outcomes for isolated acute PCL injuries. Treatment selection should be tailored to patient-specific factors, considering functional demands and injury severity.
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spelling doaj-art-7728bee69a8d4f5abcad1dc7158e9ed52025-08-20T03:43:51ZengMDPI AGSurgeries2673-40952025-03-01612410.3390/surgeries6010024Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament InjuriesRoberto Tedeschi0Federica Giorgi1Daniela Platano2Lisa Berti3Fabio Vita4Danilo Donati5Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, ItalyPediatric Physical Medicine and Rehabilitation Unit, IRCCS Institute of Neurological Sciences, 40126 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, ItalyIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic, 40136 Bologna, ItalyPhysical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy<b>Background:</b> Posterior cruciate ligament (PCL) injuries are relatively rare, with limited consensus on the optimal treatment for isolated acute cases. Conservative management and surgical reconstruction each offer potential benefits, but their comparative efficacy remains unclear. <b>Methods:</b> A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search of MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science was completed on 23 December 2024. Studies comparing conservative treatment and surgical reconstruction for isolated acute PCL injuries were included. Outcomes such as functional recovery, stability, and long-term complications were extracted and synthesized qualitatively. <b>Results:</b> Six studies were included, comprising case series, prospective, retrospective, and review designs. Conservative treatment demonstrated significant improvements in functional recovery (IKDC scores: 67–90.3/100) but showed limited improvement in stability (STSD reduction: 0–3 mm). Surgical reconstruction yielded superior stability (STSD reduction: 8.2 to 2.7 mm) and lower rates of degenerative changes but was associated with a higher risk of complications. Functional outcomes were comparable between approaches in some studies, although surgical patients showed slightly better long-term stability. <b>Conclusions:</b> Both conservative and surgical treatments achieve satisfactory outcomes for isolated acute PCL injuries. Treatment selection should be tailored to patient-specific factors, considering functional demands and injury severity.https://www.mdpi.com/2673-4095/6/1/24posterior cruciate ligamentconservative treatmentsurgical reconstructionfunctional recoveryknee stability
spellingShingle Roberto Tedeschi
Federica Giorgi
Daniela Platano
Lisa Berti
Fabio Vita
Danilo Donati
Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
Surgeries
posterior cruciate ligament
conservative treatment
surgical reconstruction
functional recovery
knee stability
title Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
title_full Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
title_fullStr Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
title_full_unstemmed Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
title_short Balancing Stability and Recovery: A Scoping Review on Conservative vs. Surgical Management of Acute Posterior Cruciate Ligament Injuries
title_sort balancing stability and recovery a scoping review on conservative vs surgical management of acute posterior cruciate ligament injuries
topic posterior cruciate ligament
conservative treatment
surgical reconstruction
functional recovery
knee stability
url https://www.mdpi.com/2673-4095/6/1/24
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