Clinical Orthopaedics and Related Research

, Volume 466, Issue 11, pp 2878–2883 | Cite as

Case Reports: Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

  • Nirav K. Pandya
  • Luke Janik
  • Gilbert Chan
  • Lawrence WellsEmail author
Case Report


Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.


Anterior Cruciate Ligament Reconstruction Posterior Cruciate Ligament Cannulated Screw Posterior Cruciate Ligament Injury Posterior Drawer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 1

A brief video made while Patient 1 was under anesthesia but before surgical repair shows he had a positive posterior drawer sign (MPG 986 kb)


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Nirav K. Pandya
    • 1
  • Luke Janik
    • 1
  • Gilbert Chan
    • 1
  • Lawrence Wells
    • 1
    Email author
  1. 1.Department of Orthopaedic SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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