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Intervention Review

Interventions for treating posterior cruciate ligament injuries of the knee in adults

  1. Maria Stella Peccin1,*,
  2. Gustavo J. M. Almeida 2,
  3. Joicemar T Amaro3,
  4. Moisés Cohen4,
  5. Bernardo Soares5,
  6. Álvaro N Atallah6

Editorial Group: Cochrane Bone, Joint and Muscle Trauma Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 19 NOV 2004

DOI: 10.1002/14651858.CD002939.pub2

Database Title

Additional Information

How to Cite

Peccin MS, Almeida GJM, Amaro JT, Cohen M, Soares B, Atallah ÁN. Interventions for treating posterior cruciate ligament injuries of the knee in adults. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD002939. DOI: 10.1002/14651858.CD002939.pub2.

Author Information

  1. 1

    Brazilian Cochrane Centre, Sao Paulo, São Paulo, Brazil

  2. 2

    University of Pittsburgh, Department of Physical Therapy, Pittsburgh, Pennsylvania, USA

  3. 3

    Instituto Cohen de Ortopedia, Reabilitação e Medicina do Esporte, Orthopaedic Department, São Paulo, SP, Brazil

  4. 4

    Federal University of São Paulo, Sports Traumatology Center, São Paulo, SP, Brazil

  5. 5

    Brazilian Cochrane Centre, São Paulo, SP, Brazil

  6. 6

    Universidade Federal de São Paulo / Escola Paulista de Medicina, Brazilian Cochrane Centre, São Paulo, SP, Brazil

*Maria Stella Peccin, Brazilian Cochrane Centre, Rua Pedro de Toledo, 598 - Vl. Clementino, Sao Paulo, São Paulo, 04039-003, Brazil. stella@institutocohen.com.br.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Injuries of the posterior cruciate ligament (PCL) of the knee frequently occur in automobile accidents and sports injuries, although they are less frequent overall than injuries of the anterior cruciate ligament (ACL). Some patients show significant symptoms and subsequent articular deterioration, while others are essentially asymptomatic, maintaining habitual function. Management of PCL injuries remains controversial and prognosis can vary widely. Interventions extend from non-operative (conservative) procedures to reconstruction of the PCL, in the hope that the surgical procedure may have a positive effect in the reduction/prevention of future osteoarthritic changes in the knee.

Objectives

To determine the effectiveness and safety of surgical and conservative interventions for PCL injuries in adults.

Search methods

We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (April 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2004), MEDLINE via PubMed (1966 to April 2004), EMBASE (1966 to April 2004), CINAHL (1982 to April 2004), LILACS (1982 to April 2004), SportsDiscus (1975 to April 2004), and reference lists of articles.

Selection criteria

Randomized or quasi-randomized clinical trials comparing various methods of operative and conservative interventions, and comparisons with each other for the treatment of PCL injuries.

Data collection and analysis

References found with the search strategy were evaluated independently by two review authors.

Main results

No randomized or quasi-randomized controlled studies meeting the selection criteria were identified.

Authors' conclusions

Future research should include randomized controlled trials of acute isolated PCL injuries, or PCL injuries when combined with other ligament injuries of the knee, treated operatively and conservatively. Adequate numbers of patients and an objective methodology for patient evaluation must be used in future studies of these interventions to determine the long-term results.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Interventions for treating posterior cruciate ligament injuries of the knee in adults

There is a lack of high quality evidence (randomized controlled trials) for the treatment of PCL injuries of the knee. Observational studies have suggested that isolated PCL injuries may be treated conservatively, with good prognosis. In more severe injuries in which the PCL is injured along with other ligaments in the knee, surgical intervention has been used. However, recommendations based on observational studies alone must be treated with caution. Future research should include randomized controlled trials of surgical and conservative interventions for PCL injuries.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

治療成年人膝蓋後十字韌帶損傷的治療法

膝蓋後十字韌帶的損傷 (Injuries of the posterior cruciate ligament; PCL)通常發生在交通事故或運動傷害中，然而整體而言後十字韌帶的損傷比起前十字韌帶(anterior cruciate ligament; ACL)的損傷較不常發生。某些病患並不會有症狀，而某些病患則會表現出較明顯的症狀且有持續性的關節惡化。 治療後十字韌帶的損傷的方法仍是很有爭議，且預後的範圍可以說是非常廣。 治療方法從非手術(保守療法)的過程到後十字韌帶的重建，我們希望透過手術的過程能夠減少甚至預防病患未來的膝關節炎的問題發生。

目標

在成年人中後十字韌帶損傷的手術及保守性療法之療效和安全性探討。

搜尋策略

我們搜尋了the Cochrane Musculoskeletal Injuries Group Specialised Register (2004年4月)、the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2004年) 、MEDLINE via PubMed (1966年 −2004年4月) 、EMBASE (1966年 −2004年4月) 、CINAHL (1982年 −2004年4月) 、LILACS (1982年 −2004年4月) 、 SportsDiscus (1975−2004年4月), 以及文章的參考文獻清單。

選擇標準

隨機試驗及半隨機臨床試驗針對後十字韌帶的損傷比較了不同的手術方法和保守性療法。

資料收集與分析

兩位作者獨立的評估所收集到的參考資料。

主要結論

沒有任何一個隨機或半隨機個控制研究有達到被選擇的標準。

作者結論

未來的研究應該要納入單獨的急性後十字韌帶損傷之隨機控制試驗，或是結合其他膝蓋韌帶損傷的後十字韌帶損傷，分別以手術及保守療法治療。 未來若要研究這些治療方法在長期的效果時，應該要納入足夠的病患數及針對病患評估作有目標性的試驗方法。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

後十字韌帶的損傷也許會發生在交通事故或運動傷害時，而其治療方法仍處於爭議中。 針對膝蓋後十字韌帶損傷的治療，我們仍然缺乏高品質的數據(隨機對照試驗)。 觀察性的研究建議，單獨的膝蓋後十字韌帶損傷應該要以保守性療法治療，才會有良好的預後。 在一些膝蓋十字後韌帶連同其他韌帶一起受傷等的較嚴重個案身上，則會使用手術的方法來治療。 然而，以保守性療法為主的建議治療仍然需要謹慎進行。 我們仍需要將針對膝蓋後十字韌帶損傷的手術及保守性療法的隨機對照試驗納入未來更進一步的研究中。

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