An all-inside arthroscopic posterior cruciate ligament reconstruction technique for children: A report of three cases

Intraligamentous rupture of the posterior cruciate ligament (PCL) is uncommon in pediatrics. The natural history of PCL tear is still little known and non-surgical management is usually advocated due to the potential growth disturbance in case of surgical reconstruction. Nonetheless, poor long-term outcomes have been reported. The purpose of this work was to report the results of surgically treated intraligamentous PCL rupture. Between 2009 and 2013, we performed three PCL reconstruction in skeletally immature patients. Age at surgery was 12, 8, and 9 years. An all-inside arthroscopic technique was applied. Outcomes were evaluated through the IKDC score, a quantitative gait analysis (QGA) and a laximetry. Mean follow-up was 6.2 years (4.5-9 years). At latest visit, all three patients were asymptomatic of their operated knee and had returned to sports at prior level. The IKDC score increased by a mean of 34 points. Our unique sole complication was an overgrowth resulting in a 15-mm-long discrepancy. The majority of children’s PCL lesions consist of bony or periosteal tibial avulsion. After a failure of conservative treatment, a case-by-case assessment for surgical indication must be carried out in a specialized team. This surgical technique used has a satisfactory mid-term reliability and is reproducible.