{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:39:52Z","timestamp":1771493992806,"version":"3.50.1"},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Posterior cruciate ligament (PCL) injuries commonly occur in association with participation in sporting or recreational activities or due to a direct trauma. Cartilage and meniscal lesions are prevalent in PCL-injured knees with increasing likelihood and severity based on extent and duration of trauma to the knee. As such, comprehensive diagnostics should be performed to ascertain all related pathology, and patients should be thoroughly educated regarding treatment options, likely sequelae including posttraumatic osteoarthritis, and associated outcomes. Treatments should address the joint as an organ, ensuring stability, alignment, and functional tissue restoration are optimized by the most efficient and effective means possible. Compliance with patient- and procedure-specific postoperative management protocols is critical for optimizing successful outcomes for these complex cases. The objectives of this review article are to highlight the likelihood and importance of osteochondral and meniscal pathology in the PCL-injured knee, and to provide the best current evidence regarding comprehensive evaluation and management for PCL-injured knees with cartilage and\/or meniscal comorbidities.<\/jats:p>","DOI":"10.1055\/s-0041-1725176","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T23:50:06Z","timestamp":1614642606000},"page":"599-604","source":"Crossref","is-referenced-by-count":2,"title":["Diagnosis and Management of Articular Cartilage and Meniscus Pathology in the Posterior Cruciate Ligament-Injured Knee"],"prefix":"10.1055","volume":"34","author":[{"given":"Michael A.","family":"Ewing","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-6494","authenticated-orcid":false,"given":"James P.","family":"Stannard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri"},{"name":"Department of Orthopaedic Surgery, Mizzou BioJoint Center, University of Missouri, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-995X","authenticated-orcid":false,"given":"James L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri"},{"name":"Department of Orthopaedic Surgery, Mizzou BioJoint Center, University of Missouri, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/BOT.0b013e318270def4","article-title":"Investigation of multiligamentous knee injury patterns with associated injuries presenting at a level I trauma center","volume":"27","author":"E H Becker","year":"2013","journal-title":"J Orthop Trauma"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/00005131-200303000-00008","article-title":"Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases","volume":"17","author":"B C Twaddle","year":"2003","journal-title":"J Orthop Trauma"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.1177\/0363546515572770","article-title":"Emerging updates on the posterior cruciate ligament: a review of the current literature","volume":"43","author":"C M LaPrade","year":"2015","journal-title":"Am J Sports Med"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00167-012-2132-1","article-title":"An isolated rupture of the posterior cruciate ligament results in reduced preoperative knee function in comparison with an anterior cruciate ligament injury","volume":"21","author":"A Ar\u00f8en","year":"2013","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1177\/0095399703258794","article-title":"The effect of posterior cruciate ligament reconstruction on patellofemoral contact pressures in the knee joint under simulated muscle loads","volume":"32","author":"T J Gill","year":"2004","journal-title":"Am J Sports Med"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.arthro.2004.12.012","article-title":"Intra-articular findings in the reconstructed multiligament-injured knee","volume":"21","author":"C C Kaeding","year":"2005","journal-title":"Arthroscopy"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1177\/0363546504265005","article-title":"The effect of posterior cruciate ligament deficiency on knee kinematics","volume":"32","author":"M Logan","year":"2004","journal-title":"Am J Sports Med"},{"issue":"12","key":"ref8","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s00256-016-2495-3","article-title":"Intra-articular pathology associated with isolated posterior cruciate ligament injury on MRI","volume":"45","author":"M D Ringler","year":"2016","journal-title":"Skeletal Radiol"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"694","DOI":"10.2106\/00004623-199305000-00008","article-title":"The effects of sectioning of the posterior cruciate ligament and the posterolateral complex on the articular contact pressures within the knee","volume":"75","author":"M J Skyhar","year":"1993","journal-title":"J Bone Joint Surg Am"},{"issue":"09","key":"ref10","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.1007\/s11999-014-3707-6","article-title":"Long-term followup of surgically treated knee dislocations: stability restored, but arthritis is common","volume":"472","author":"G C Fanelli","year":"2014","journal-title":"Clin Orthop Relat Res"},{"issue":"01","key":"ref11","first-page":"8","article-title":"Posterior cruciate ligament: current concepts review","volume":"6","author":"S Pache","year":"2018","journal-title":"Arch Bone Jt Surg"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1007\/s00167-020-05919-4","article-title":"Posterior cruciate ligament lesions are mainly present as combined lesions even in sports injuries","volume":"28","author":"M Schlumberger","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1177\/036354658701500606","article-title":"Isolated posterior cruciate ligament injuries in athletes","volume":"15","author":"P J Fowler","year":"1987","journal-title":"Am J Sports Med"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"2384","DOI":"10.1007\/s00167-015-3786-2","article-title":"Epidemiology of surgically treated posterior cruciate ligament injuries in Scandinavia","volume":"25","author":"C Owesen","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0749-8063(00)90128-2","article-title":"Chondral injury associated with acute isolated posterior cruciate ligament injury","volume":"16","author":"M Hamada","year":"2000","journal-title":"Arthroscopy"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1007\/s00167-015-3540-9","article-title":"Meniscal tears and articular cartilage damage in the dislocated knee","volume":"23","author":"A J Krych","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"08","key":"ref17","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s00167-006-0039-4","article-title":"Surgical treatment of multiple knee ligament injuries in 44 patients: 2-8 years follow-up results","volume":"14","author":"M Tzurbakis","year":"2006","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2106\/JBJS.H.00177","article-title":"Analysis of tibiofemoral cartilage deformation in the posterior cruciate ligament-deficient knee","volume":"91","author":"S K Van de Velde","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1177\/0363546513504287","article-title":"Kinematic analysis of the posterior cruciate ligament, part 1: the individual and collective function of the anterolateral and posteromedial bundles","volume":"41","author":"N I Kennedy","year":"2013","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1177\/036354659302100615","article-title":"Intraarticular abnormalities in association with posterior cruciate ligament injuries","volume":"21","author":"W B Geissler","year":"1993","journal-title":"Am J Sports Med"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1053\/jars.2003.50037","article-title":"Arthroscopic evaluation of articular cartilage lesions in posterior-cruciate-ligament-deficient knees","volume":"19","author":"M J Strobel","year":"2003","journal-title":"Arthroscopy"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00402-017-2855-z","article-title":"Degenerative changes after posterior cruciate ligament reconstruction are irrespective of posterior knee stability: MRI-based long-term results","volume":"138","author":"C Gwinner","year":"2018","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jor.2020.03.036","article-title":"Outcomes associated with behavioral evaluation and counseling for patients undergoing orthopaedic surgery - a systematic review","volume":"21","author":"R Hayden","year":"2020","journal-title":"J Orthop"},{"key":"ref24","volume-title":"DeLee, Drez, & Miller's Orthopaedic Sports Medicine: Principal and Practice","author":"M D Miller","year":"2020","edition":"5th ed."},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2739\/kurumemedj.44.135","article-title":"Hemarthrosis of the knee and bone contusion","volume":"44","author":"M Ariyoshi","year":"1997","journal-title":"Kurume Med J"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1053\/apmr.2003.50026","article-title":"Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests","volume":"84","author":"G A Malanga","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1055\/s-0034-1367731","article-title":"MRI versus ultrasonography to assess meniscal abnormalities in acute knees","volume":"27","author":"J L Cook","year":"2014","journal-title":"J Knee Surg"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/02841850510021067","article-title":"Posterolateral complex knee injuries: magnetic resonance imaging with surgical correlation","volume":"46","author":"D J Theodorou","year":"2005","journal-title":"Acta Radiol"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1007\/s00167-015-3861-8","article-title":"A systematic review and meta-analysis of the diagnostic accuracy of MRI for suspected ACL and meniscal tears of the knee","volume":"24","author":"N Phelan","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"02","key":"ref30","first-page":"121","article-title":"Accuracy of MRI diagnosis of meniscal tears of the knee: a meta-analysis and systematic review","volume":"34","author":"W Wang","year":"2019","journal-title":"J Knee Surg"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s12306-016-0427-y","article-title":"Comparison of clinical, MRI and arthroscopic assessments of chronic ACL injuries, meniscal tears and cartilage defects","volume":"100","author":"L Felli","year":"2016","journal-title":"Musculoskelet Surg"},{"issue":"08","key":"ref32","first-page":"e1060","article-title":"3.0-Tesla MRI and arthroscopy for assessment of knee articular cartilage lesions","volume":"36","author":"M E Reed","year":"2013","journal-title":"Orthopedics"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"20140542","DOI":"10.1259\/bjr.20140542","article-title":"Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects","volume":"88","author":"D S Evangelopoulos","year":"2015","journal-title":"Br J Radiol"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.arthro.2018.09.030","article-title":"Cost-effectiveness analysis of needle arthroscopy versus magnetic resonance imaging in the diagnosis and treatment of meniscal tears of the knee","volume":"35","author":"N Amin","year":"2019","journal-title":"Arthroscopy"},{"issue":"09","key":"ref35","doi-asserted-by":"crossref","first-page":"2325967119869846","DOI":"10.1177\/2325967119869846","article-title":"Risks and complications associated with intra-articular arthroscopy of the knee and shoulder in an office setting","volume":"7","author":"S McMillan","year":"2019","journal-title":"Orthop J Sports Med"},{"issue":"09","key":"ref36","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1016\/j.arthro.2019.03.045","article-title":"In-office needle arthroscopy: a systematic review of indications and clinical utility","volume":"35","author":"K Zhang","year":"2019","journal-title":"Arthroscopy"},{"issue":"02","key":"ref37","doi-asserted-by":"publisher","DOI":"10.12788\/ajo.2018.0007","article-title":"Use of a small-bore needle arthroscope to diagnose intra-articular knee pathology: comparison with magnetic resonance imaging","volume":"47","author":"C A Deirmengian","year":"2018","journal-title":"Am J Orthop"},{"issue":"11","key":"ref38","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1055\/s-0040-1712944","article-title":"Clinical application of the basic science of articular cartilage pathology and treatment","volume":"33","author":"A J Schreiner","year":"2020","journal-title":"J Knee Surg"},{"issue":"05","key":"ref39","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1016\/j.knee.2020.07.087","article-title":"BioCartilage augmentation of marrow stimulation procedures for cartilage defects of the knee: Two-year clinical outcomes","volume":"27","author":"C M Brusalis","year":"2020","journal-title":"Knee"},{"issue":"06","key":"ref40","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1177\/0363546520907101","article-title":"Prospective assessment of outcomes after primary unipolar, multisurface, and bipolar osteochondral allograft transplantation in the knee: A comparison of 2 preservation methods","volume":"48","author":"J P Stannard","year":"2020","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref41","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/j.knee.2020.09.015","article-title":"Initial clinical outcomes comparing frozen versus fresh meniscus allograft transplants","volume":"27","author":"A J Schreiner","year":"2020","journal-title":"Knee"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1710361","article-title":"Patient-reported outcomes for large bipolar osteochondral allograft transplantation in combination with realignment osteotomies for the knee","author":"B P Zitsch","year":"2020","journal-title":"J Knee Surg"},{"issue":"11","key":"ref43","doi-asserted-by":"crossref","first-page":"2325967119884291","DOI":"10.1177\/2325967119884291","article-title":"Effects of compliance with procedure-specific postoperative rehabilitation protocols on initial outcomes after osteochondral and meniscal allograft transplantation in the knee","volume":"7","author":"K Rucinski","year":"2019","journal-title":"Orthop J Sports Med"},{"issue":"01","key":"ref44","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1055\/s-0040-1718605","article-title":"Postoperative management for articular cartilage surgery in the knee","volume":"34","author":"C R Crecelius","year":"2021","journal-title":"J Knee Surg"},{"issue":"01","key":"ref45","first-page":"2325967120967928","article-title":"Return to sport after large single surface, multisurface, or bipolar osteochondral allograft transplantation in the knee using shell grafts","volume":"9","author":"J L Cook","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"08","key":"ref46","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1177\/0363546509333479","article-title":"Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study","volume":"37","author":"S Hermans","year":"2009","journal-title":"Am J Sports Med"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/0363546507311091","article-title":"Cartilage damage determines intermediate outcome in the late multiple ligament and posterolateral corner-reconstructed knee: a 5- to 10-year follow-up study","volume":"36","author":"K Corten","year":"2008","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref48","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1302\/0301-620X.79B6.0791008","article-title":"Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee","volume":"79","author":"M T Ghazavi","year":"1997","journal-title":"J Bone Joint Surg Br"},{"issue":"04","key":"ref49","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1177\/0363546514536021","article-title":"Meniscal allograft transplantation: a systematic review","volume":"43","author":"F Rosso","year":"2015","journal-title":"Am J Sports Med"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1725176.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T23:23:34Z","timestamp":1620689014000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1725176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,1]]},"references-count":49,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2021,5,10]]},"published-print":{"date-parts":[[2021,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1725176","relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,1]]}}}