The PCL Envelope Lack Sign (PELS) Is a Direct Arthroscopic Sign of Chronic Posterior Cruciate Ligament Insufficiency

Purpose: To present the arthroscopic “PCL envelope lack sign” (PELS) and to calculate its diagnostic characteristics in chronic PCL insufficiency. Methods: Recordings of knee arthroscopies performed a single clinic between April 2015 March 2020 were retrospectively evaluated, searching for envelope”. It was defined as “soft tissue cuff coursing around tibial attachment, visible with arthroscope positioned PCL, medial femoral condyle posterior horn meniscus at level shiny white fibers”. PELS “the adhering proximal tibia adjacent meniscal root inability observe normal space no soft attachment”. Inclusion criteria possibility evaluate presence on recordings. Patients who underwent reconstruction assigned study group. The rest patients controls. Criteria operate symptomatic least 5 mm instability physical examination 6 months post-injury. Results: Out 614 available recordings, 592 (205 females, 387 males; mean age 45.2 years, SD = 14.36, range 14–81) included: 38 group 554 control In group, positive 36 cases (94.7%). negative PCL-efficient (100%). Calculated sensitivity 94.7%, specificity 100%, predictive value 99.6%. significantly more often PCL-insufficient patients, p < 0.001. Conclusions: sign found be highly effective tool arthroscopically confirm insufficiency, should considered direct instability.