Posterior Cruciate Ligament

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What is an PCL injury?

The PCL is one of 4 major ligaments in the knee. It keeps the tibia (lower leg bone) from sliding posterior to the femur (thighbone). It often occurs with other ligament or cartilage injuries. The most common causes of PCL tears are falls on the anterior knee or car accidents.

Symptoms:

  • Pain, swelling, and instability after the injury.
  • Sometimes a pop is felt or heard.

Diagnosis:

  • X-rays are used to check for fractures. Specific stress X-rays can evaluate the laxity of the PCL (how far it can be shifted from its initial position).
  • MRI is often used to evaluate the extent of the PCL injury and any other injuries.

Treatment:

  • Initial treatment includes rest and physical therapy to strengthen the quadriceps.
  • Surgical reconstruction is recommended when a patient continues to experience persistent instability despite completing a physical therapy program and having adequate quadriceps strength.
  • Surgery involves reconstructing the PCL. Surgeons use donor tissue (allograft) or a patient’s own tissue (usually a portion of the quadriceps tendon) to reconstruct the PCL.

Postoperative Care:

  • Patients may need to stay in the hospital for 1-2 days after surgery for pain control.
  • Crutches and a brace (or splint) will need to be used for about a month after surgery.
  • Physical therapy begins soon after surgery to regain range of motion and strength. Most patients need physical therapy for 3–6 months.
  • Full recovery is approximately 6–9 months after surgery. Many athletes take a full year to completely recover before they return to sports.

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