Injury to the posterior cruciate ligament (PCL) is most commonly seen in the setting of a multiligamentous injured knee, and isolated PCL tears are rare. PCL injuries are generally treated either conservatively or by PCL reconstruction using a graft. If a proximal or distal tear is present, the injured ligament can also be treated by primary repair, in which the ligament is reattached to the tibial or femoral insertion. This has the (theoretical) advantages of preserving the native tissue, maintaining proprioception, and can be performed in a less invasive way when compared with reconstruction surgery. In this review, the appropriate patient selection, surgical indications, surgical techniques, and outcomes of primary repair of proximal and distal PCL tears will be discussed. Primary repair may be an alternative treatment for PCL reconstruction if appropriate patient selection is applied.
