Long-term Follow-up of Patients with Acute Posterior Cruciate Ligament Injury Treated Non-operatively with a Physiotherapy-led Exercise and Support Brace Intervention.
Randi G Rasmussen, Birgitte Blaabjerg, Torsten G Nielsen and 1 others
PMID 40322513WHAT IT FOUND
Most patients with acute PCL injuries treated with a brace and physiotherapy reported improved knee function five years later.
Surgery was rarely needed after two years. However, multiligament injuries showed lower scores and a higher surgery rate, suggesting knee dislocations may need early surgical consideration.
Key findings
01Patient-reported outcomes improved significantly from baseline to five years, with IKDC scores rising from 36 to 79 points.
02Seven patients required surgery within two years, but no patients needed conversion to surgery between two and five years.
03Patients with multiligament injuries had lower initial and five-year scores than those with isolated injuries, and a higher conversion rate to surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
No control group was included, so improvements cannot be definitively attributed to the specific intervention rather than natural healing. Attrition occurred: only 36 of 50 patients completed the five-year follow-up, risking bias if those who dropped out had worse outcomes. Rehabilitation adherence was not documented, so it is unclear how much exercise the patients actually performed. The study was underpowered to detect clinically relevant differences between isolated and multiligament injury subgroups.
The easy way to misread this
Do not assume the brace and exercise intervention caused the improvement. There was no control group, so the results reflect the natural history of PCL injuries treated non-operatively, not necessarily the specific efficacy of this protocol.