# Impact of Ligamentous Adhesion to the Posterior Cruciate Ligament on Radiological, Arthroscopic, and Clinical Outcomes One Year After ACL Reconstruction: A Cohort Study: -

## TL;DR

This study examines how adhesion between the ACL and PCL after surgery affects knee recovery, finding no significant impact on short-term outcomes.

## Contribution

The study identifies the prevalence of ACL–PCL adhesion and evaluates its clinical relevance after ACL reconstruction.

## Key findings

- ACL remnant adhesion to the PCL was observed in 85.1% of patients.
- Adhesion was not associated with adverse radiological or clinical outcomes in the short term.

## Abstract

The anterior cruciate ligament (ACL) and posterior cruciate ligament
(PCL) play a crucial role in maintaining knee stability by controlling
anterior
and posterior tibial translation. After ACL reconstruction, residual ACL
tissue
may adhere to the PCL, potentially altering knee biomechanics and affecting
postoperative recovery. The clinical significance of this adhesion remains
uncertain. This study aimed to evaluate the relationship between ACL–PCL
adhesion and radiological, arthroscopic, and clinical outcomes one year
after
ACL reconstruction.

This retrospective cohort study
included patients with ACL tears who underwent reconstructive surgery at
hospitals in Tehran between 2022 and 2023. Patients were divided into two
groups
based on arthroscopic findings: those with ACL remnant adhesion to the PCL
and
those without adhesion. Demographic data, postoperative MRI findings
(chondral
lesions, articular cartilage damage, meniscal injuries, varus deformity, and
concomitant ligament injuries), and clinical outcomes assessed by Lachman
and
pivot shift tests were compared between groups. Statistical analysis was
performed using SPSS software using chi-square and McNemar’s tests.

A total of 87 patients were evaluated (mean age 30.42 ± 5.79 years),
including 78
males and 9 females. ACL remnant adhesion to the PCL was observed in 74
patients
(85.1%). Articular cartilage damage was more frequent in the non-adhesion
group
(23.1%). Medial meniscal injuries were present in 56.3% of patients and were
more common in the non-adhesion group (76.9%). Lateral and root meniscal
injuries, as well as concomitant MCL and PCL injuries, were more frequently
observed in the adhesion group. Varus deformity showed no significant
association with adhesion status. No significant differences were found in
Lachman or pivot shift test results, and adhesion was not associated with
age or
gender.

ACL remnant adhesion to the PCL is a common finding after
ACL reconstruction but was not associated with adverse radiological findings
or
short-term clinical outcomes. Further studies are needed to assess its
long-term
clinical relevance.