The posterior cruciate ligament (PCL) is one of the most prominent ligaments in the knee. Injuries to the posterior cruciate ligament can occur in a variety of ways, including a hard blow to the shinbone or falling down on a bent knee. These injuries most frequently occur during motor vehicle accidents and participation in contact sports. A PCL injury can also be the result of bending your knee past the normal anatomical position, over-extending it or sustaining a blow to the side of your knee while your leg is twisted. If you have a posterior cruciate ligament injury, some symptoms you may notice are pain in your knee, rapid swelling and tenderness, painful kneeling and squatting, limping or difficulty walking, your knee giving way while active and feelings of instability and pain with running, walking or climbing stairs. The discomfort and inconvenience associated with a PCL injury cause your activity to be limited, and affect your quality of life. Pursuing repair of your posterior cruciate ligament injury, such as PCL reconstruction surgery, will relieve your pain and discomfort and help you get back to your normal life.
Posterior Cruciate Ligament (PCL) Injury Diagnosis
When you present with a PCL injury, your physician will perform a physical assessment, look at your past medical history and current medications, assess the presence of symptoms, cause of the injury and your ability to perform physical activities. Talking with your doctor will provide insight into the extent of your injuries and the appropriate treatment for your condition. Your physician will order diagnostic tests to allow a visual examination of your injuries, enabling them to objectively determine the appropriate treatment. Some examples of diagnostic imagery include:
Nonsurgical Treatment for Posterior Cruciate Ligament (PCL) Tears and Injuries
In many cases, a partial or isolated PCL tear can be treated in a nonsurgical manner. The posterior cruciate ligament contains a synovial covering which has self-healing abilities, and surgical intervention may not be necessary for recovery. Your orthopaedic specialist will provide instructions on care at home, which may include resting the injured leg to prevent further injury (with or without the use of crutches), anti-inflammatory medications, ice or heat therapy, compression with bandage wraps and elevation to reduce swelling. Joint aspiration, an invasive but nonsurgical technique, may occur to remove the joint fluid if there is significant swelling in the knee that is preventing normal range of motion or ability to use the knee or leg. Following your physician’s orders will allow your injured PCL to heal, without further complications that may require surgical intervention.
Surgery for Posterior Cruciate Ligament (PCL) Reconstruction
Some indications of posterior cruciate ligament reconstruction surgery include injuries that occur with other ligament tears associated with the knee; those that occur as a result of a bone avulsion injury or a peel-off injury; and chronic PCL injuries symptomatic with pain and instability. There are different grafting choices, including autogenous (from the self) patellar or quadriceps tendon with bone blocks and hamstring tendons; and allograft (from a donor) patellar tendon or Achilles tendon. PCL reconstruction procedures are usually performed using one of the following techniques:
Posterior Cruciate Ligament (PCL) Reconstruction Procedure Research
Conservative therapy is normally indicated for Grade 1 and 2 PCL injuries (mild and moderate), with surgery normally indicated for Grade 3 (complete PCL tear). The incidence of complications arising after posterior cruciate ligament reconstruction surgery is approximately 1%. Current procedures for PCL reconstruction allow 85-90% of patients to return to full activity.
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.
The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute in New York performs posterior cruciate ligament surgery, along with a number of other treatments – both surgical and non-surgical – for bone and joint conditions and injuries.