Operative and non‐operative management can result in acceptable long‐term outcomes for isolated posterior cruciate ligament injuries in paediatric patients

Abstract Purpose The purpose of this study was to evaluate the injury characteristics, treatment, and outcome of paediatric patients with isolated posterior cruciate ligament (PCL) injuries treated at a single center. Authors hypothesised that both treatment cohorts would successfully return to sport participation with a low risk of PCL retear or ongoing knee‐related symptoms. Methods A retrospective review and cross‐sectional outcomes assessment were performed identifying patients <18 years old with PCL injuries from a single treatment center between 2015 to 2021 using ICD‐10 coding. Patients with concomitant collateral or cruciate ligament injury were excluded. Studied variables included patient demographics, injury characteristics, treatment strategies, and patient outcomes (PROMIS, IKDC and Lysholm scores and reinjury). A cross‐sectional follow‐up survey was distributed to all patients in spring 2023. Descriptive statistics were performed for continuous and categorical outcomes. Bivariate analyses were performed on all variables between operative and nonoperative treatment groups. A non‐response analysis was completed to evaluate non‐response bias of the cross‐sectional cohort due to the incomplete response rate. Results Twenty‐four patients meeting inclusion criteria were identified. Injured patients had a mean age of 13.2 years old and were predominantly male (67%). Injuries most occurred during sport participation (75%) and were managed nonoperatively (67%). Overall, there were no differences between treatment groups regarding complications or return to sport. Eleven (46%) completed the cross‐sectional outcomes assessment at an average of 4.7 years from injury. Most patients had successfully returned to sport without sustaining an ipsilateral knee injury with patient reported outcome scores within normative ranges. Conclusion These results suggest that both operative and non‐operative treatment strategies are reasonable in the short‐ and long‐term management of paediatric PCL injuries. Level of Evidence Level IV.