Interventions for treating posterior cruciate ligament injuries of the knee in adults.

BACKGROUND: Injuries of the posterior cruciate ligament (PCL) of the knee frequently occur in automobile accidents and sports injuries, although they are less frequent overall than injuries of the anterior cruciate ligament (ACL). Some patients show significant symptoms and subsequent articular deterioration, while others are essentially asymptomatic, maintaining habitual function. Management of PCL injuries remains controversial and prognosis can vary widely. Interventions extend from non-operative (conservative) procedures to reconstruction of the PCL, in the hope that the surgical procedure may have a positive effect in the reduction/prevention of future osteoarthritic changes in the knee. OBJECTIVES: To determine the effectiveness and safety of surgical and conservative interventions for PCL injuries in adults. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group Specialised Register (April 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2004), MEDLINE via PubMed (1966 to April 2004), EMBASE (1966 to April 2004), CINAHL (1982 to April 2004), LILACS (1982 to April 2004), SportsDiscus (1975 to April 2004), and reference lists of articles. SELECTION CRITERIA: Randomized or quasi-randomized clinical trials comparing various methods of operative and conservative interventions, and comparisons with each other for the treatment of PCL injuries. DATA COLLECTION AND ANALYSIS: References found with the search strategy were evaluated independently by two review authors. MAIN RESULTS: No randomized or quasi-randomized controlled studies meeting the selection criteria were identified. AUTHORS' CONCLUSIONS: Future research should include randomized controlled trials of acute isolated PCL injuries, or PCL injuries when combined with other ligament injuries of the knee, treated operatively and conservatively. Adequate numbers of patients and an objective methodology for patient evaluation must be used in future studies of these interventions to determine the long-term results.

Correlacao entre a dor anterior do joelho e a medida do angulo ``Q`` por intermedio da fotometria computadorizada / Correlation between knee anterior pain and measure of q angel through computerized photometry

A dor anterior do joelho (DAJ) se caracteriza por uma dor em geral nao especifica presente de forma difusa,com possibilidade de irradiacao para a regiao poplitea. Seu inicio geralmente e insidioso, podendo aumentar ao subir e descer escadas, durante a pratica de atividade fisica, na manutencao por prolongado periodo de flexao do joelho ( Sinal do cinema ) e posicao de agachamento, podendo tambem ser acompanhada de pseudobloqueios. Varios autores correlacionam a DAJ com o aumento do angulo Q . No entanto, esse fator etiologico tem sido questionado, principalmente por essa medida ser estatica. Assim, o objetivo deste trabalho foi correlacionar a dor anterior do joelho com o angulo Q por intermedio da fotometria computadorizada. Foram estudados 58 joelhos de 29 individuos, com faixa etaria compreendida entre 15 e 34 anos (x=22,sd=4,1, divididos em dois grupos: grupo A, composto por 11 individuos (22 joelhos) que apresentavam episodios de dor bilateral, e grupo B, composto por 18 individuos (36 joelhos) sem nenhum episodio de dor. Para a correlacao entre os indices de dor e a medida do angulo Q nos joelhos dos individuos sintomaticos, foi aplicada a prova do Coeficiente de Correlacao por postos de Spearman, a qual verificou como resultado, dentro das condicoes experimentais utilizadas, correlacao direta negativa entre o aumento dos valores do angulo Q e a presenca da dor anterior no joelho. Dessa forma, quando analisado de maneira isolada, o aumento do angulo Q nao deve ser considerado fator etiologico da DAJ.