Prof Dr Wilson, how many posterior cruciate ligaments (PCL) do you treat each year?
"I do around twelve PCL treatments a year."
What is the ratio between conservative and operative care?
"Here in the UK, patients with this type of injury generally do not go to the doctor in the acute stage. This applies even to severe PCL injuries. It is therefore almost always a chronic condition and has to be treated operatively. If patients do come to us in the acute phase, we treat PCL injuries conservatively if possible."
How do you treat PCL injuries?
"I am a supporter of the conservative method. That is to say: Firstly, the patient must not put any weight on his knee for six weeks, and this is followed by gradual application of weight and then full weight application after twelve weeks. However, if an operation is necessary, our patients are given the medi PTS immobilising brace for two weeks and are not allowed to move their knee during this time. After this, they are given a dynamic leg brace. We then increase the extent of movement over four periods, i.e. from 0 to 30 degrees, to 0 to 60 degrees, then to 0 to 90 degrees. After six weeks, movement is unlimited. Patients wear the leg brace as often as possible over a period of three months."
What property must a knee brace have to make it particularly suitable for PCL treatment?
"Earlier knee braces for the PCL were not particularly comfortable to wear, as they were bulky and large. This meant that compliance was poor. The leg braces still looked very new after a three-month wearing period, since they were so uncomfortable that people didn't wear them. In contrast, people cope very well with the M.4s PCL dynamic brace. You only need to lift it up: It is very light. The brace is easy to put on and adjust individually. And patients can also wash themselves. In the six months in which I have been using it, I have found that compliance is extraordinarily good for this brace."
What property of the M.4s PCL dynamic do you like most?
"In my view, the quick, easy adjustment of the support pad with the integrated rotating knob is a great advantage. This means that the effect of the brace can really come into play both in conservative treatment and after an operative reconstruction. For me, this is the best property."
When do you feel that an immobilising leg brace like the medi PTS is necessary?
"Clearly, in the acute stage, when the patient comes to the doctor in the first days after his injury with swelling and pain. This brace is ideal for immobilising the knee, as it is very comfortable. Once the swelling has gone down and the pains have eased, a dynamic brace can be applied after two weeks."
Prof Dr Wilson, thank you very much for the interview.