Associated Injuries in MRI-Confirmed Posterior Cruciate Ligament Tears: A Retrospective Study From Saudi Arabia

Objective: This retrospective study aimed to evaluate concomitant injuries in patients with isolated posterior cruciate ligament (PCL) tears, focusing on fractures, meniscal, chondral, and ligamentous pathologies. Methods: At King Abdulaziz Medical City, Riyadh, Saudi Arabia (2017–2019), 94 patients with magnetic resonance imaging (MRI)-confirmed isolated PCL tears were analysed. Data included demographics, injury mechanism (traumatic/sports), tear grade (I–III), acuity (acute/chronic), associated injuries, and management. Musculoskeletal radiologists validated MRI findings. Statistical analysis was conducted using Statistical Package for the Social Sciences 20, with χ² and Mann–Whitney U tests (significance set at p < 0.05). Results: A total of 94 patients, most of whom were above the age of 50 years (35.1%), were included, with trauma as the primary mechanism (67%). Complete PCL tears (56.4%) predominated. Lateral tibial fractures (22.3%), medial meniscal tears (45.2%), and anterior cruciate ligament (ACL) injuries (37.2%) were common. Complete PCL tears correlated with lateral tibial fractures (p = 0.002), while partial tears were associated with lateral meniscal injuries (p = 0.011). ACL injuries coexisting with PCL tears were significantly associated with the medial collateral ligament (p = 0.0001), lateral collateral ligament (p = 0.01), and lateral meniscal injuries (p = 0.002). A major limitation of this study is the absence of follow-up data for 86% of patients, which limits the evaluation of long-term outcomes and treatment responses. Conclusion: The findings of this study underscore the importance of comprehensive assessment for concomitant injuries when evaluating PCL tears. This is the first study in the region to characterize the injury patterns and associations of PCL tears using a local dataset, providing a valuable baseline for future clinical and epidemiological research.