Posterior Cruciate Ligament Injury - (PCL Injury)

Knee injuries can disrupt daily life and athletic performance, and one of the most overlooked yet critical injuries involves the posterior cruciate ligament (PCL). As a primary stabilizer of the knee, the PCL prevents the shinbone (tibia) from shifting backward relative to the thighbone (femur). At Rothman Orthopaedics, we provide expert care for all PCL injuries, whether through non-surgical rehabilitation or advanced surgical options, ensuring patients achieve optimal recovery and return to their favorite activities.

 

What is a PCL Injury?

The PCL, located at the back of the knee, is broader and stronger than the anterior cruciate ligament (ACL). Together, these ligaments form an "X" within the knee joint, stabilizing forward and backward motion.

While ACL injuries are more common, the PCL is injured in only 2% of isolated ligament injuries. This is because the PCL requires significant force to tear. Such injuries often occur in high-impact sports like football, soccer, basketball, and skiing. Common mechanisms of injury include:

• Hyperextension: For example, a football player tackled directly at the knee may sustain a PCL tear due to forceful hyperextension.
• Blunt Trauma: A basketball player landing on a bent knee or a car accident where the knee strikes the dashboard can disrupt the PCL.

In some cases, PCL injuries occur alongside damage to other knee ligaments, cartilage, or bones, requiring comprehensive evaluation and treatment.

 

Symptoms of PCL Injuries

Symptoms of a PCL injury can vary depending on its severity. They may include:

• Pain and swelling: These typically occur rapidly after the injury.
• Instability: The knee may feel as though it is "giving out" or shifting.
• Difficulty walking: Due to pain or weakness.
• Tenderness at the back of the knee: This is a hallmark sign of PCL involvement.
• Gradual worsening: In mild cases, symptoms may not immediately present but worsen over time, with increasing instability and discomfort.

 

Diagnosis of PCL Injuries

A thorough evaluation by a sports medicine specialist is crucial to determine the severity of the injury and appropriate treatment options. The diagnostic process typically involves:

1. Physical Examination: A physician will assess ligament stability using specific tests, such as the posterior drawer test, which evaluates backward movement of the tibia relative to the femur.
2. Imaging Studies:
   • X-rays to rule out fractures.
   • MRI scans to confirm the extent of ligament and cartilage damage.
3. Swelling and Tenderness: Observing for signs of swelling and palpating the knee for pain along the ligament.

 

Severity of PCL Injuries

PCL injuries are classified into three grades:

• Grade 1: Mild stretching of the ligament, which remains functional and stabilizes the knee.
• Grade 2: Partial tear, causing looseness and mild instability.
• Grade 3: Complete tear, resulting in significant instability and often requiring surgical intervention. Grade 3 injuries are often encountered with other ligament injuries around the knee and are rarely isolated.

 

Treatment Options for PCL Injuries

Non-Surgical Treatment

Most Grade 1 and Grade 2 injuries can heal with conservative measures, such as:

• R.I.C.E.: Rest, Ice, Compression, and Elevation to reduce swelling and pain.
• Immobilization: A brace or crutches may be used to restrict movement and prevent further damage.
• Medications: Over-the-counter anti-inflammatory drugs to manage pain and swelling.
• Physical Therapy: A personalized rehabilitation program to strengthen the quadriceps and restore stability to the knee.
• Return to normal activity or sports may take 3-6 months.

Surgical Treatment

Surgical intervention is typically recommended for:

• Grade 3 injuries: Complete ligament tears.
• Combined injuries: Damage involving other knee ligaments, cartilage, or bones.

The procedure often involves PCL reconstruction, where a tissue graft is used to rebuild the ligament. Surgeons at Rothman Orthopaedics use advanced, minimally invasive techniques to reduce recovery time and improve surgical outcomes.

 

Recovery and Rehabilitation

Recovery depends on the severity of the injury and adherence to a rehabilitation program. Post-surgery, patients typically require:

• 6–12 months of physical therapy to regain full strength and stability.
• Close monitoring to ensure proper healing and prevent reinjury.

 

Why Choose Rothman Orthopaedics for PCL Treatment?

At Rothman Orthopaedics, our experienced team delivers compassionate, state-of-the-art care tailored to each patient’s needs. With access to advanced diagnostics, innovative surgical techniques, and comprehensive rehabilitation programs, we focus on achieving the best possible outcomes for every individual.

Our specialists are highly experienced in treating PCL injuries and are committed to helping you recover and return to your active lifestyle. Don’t let a PCL injury hold you back—our experts are here to help you return to your active lifestyle.

 

For more information or to schedule an appointment, visit Rothman Orthopaedics online or call us at 1-800-321-9999.