Knee Laxity or Loss of Knee Range of Motion after PCL Reconstruction: A Systematic Review and Meta-Analysis

Background. PCL reconstruction is a successful method for enhancing the patient's quality of life but posterior knee laxity and knee stiffness have still occurred surgery. There is no study to evaluate knee laxity or loss of knee range of motion after surgery. Objectives. To assess the outcomes after PCL reconstruction, we: 1) evaluated the range of motion of the knee, 2) evaluated posterior knee laxity, and 3) determined the factors that influence laxity or the loss of range of motion after surgery. Methods. Articles that met the following criteria were enrolled in this review: 1) articles on peer-reviewed level 1 to 4 studies; 2) articles published in English; 3) articles on PCL reconstruction studies; 4) articles on isolated PCL rupture; 5) articles that describe laxity after surgery and 6) articles that describe the degree of range of motion after surgery. Results. Involving a total of 1711 patients. There was a loss of extension and flexion after PCL reconstruction (9.15% and 28.9%, respectively). Knee laxity was still observed at the final examination in the posterior drawer test, KT 1000/2000 test, and Telos radiographic view (64.8%, 42.8%, and 47.9%, respectively). In the subgroup analysis, there was no significant difference in laxity between allograft group vs autograft group using the KT 1000/2000 measurement (mean difference [MD] = -0.42, 95% confidence interval [-1.41, 0.56], p = 0.40), Single Bundle vs Double Bundle (DB) using the KT 1000/2000 measurement (MD = -0.003, 95% CI [-1.35, 1.29], p < 0.00001), and transtibial vs tibial inlay using the Telos radiograph measurement (MD = 0.03, 95% CI [-0.33, 0.39], p = 0.88), but DB significantly improved knee stability using the Telos radiographic measurement (MD = 0.69, 95% CI [0.29,1.09], p = 0.00008). Conclusion. This study demonstrates that the loss of range of motion or laxity is still a problem after PCL reconstruction.