A posterior cruciate ligament injury is a sprain- a stretch or tear of the ligament- in the knee that runs from the front of the femur (thigh bone) to the back of the tibia (lower leg bone) and prevents backward movement of the tibia in relation to the femur. The PCL is stronger than the ACL and is injured much less often. Isolated PCL injuries without injury to any other structure in the knee only occur about 2% of the time.
Symptoms
- Immediate swelling
- Pain in the interior of the knee and toward the back of the knee
- Hearing or feeling a loud “pop” in the knee
- Stiffness or rigidity
- Instability or the feeling the knee is going to “give out”
- Possible inability to put pressure on the knee when walking
Causes
- Forceful hyperextension of the knee
- Direct hit to the front of the knee right below the knee cap
- A powerful twist of the knee
- A car accident causing a bent knee to hit the dash board in the car
Risk factors
- Powerful force such as a car accident
- Collision or contact sports
Prevention
- Avoid collision or contact sports
- Avoid any high impact activity
Diagnosis
- Physician evaluation is necessary
- A torn PCL may look like the knee is “sagging” backward when held up at 90 degrees of flexion.
- X-ray necessary to rule out fracture
- MRI necessary to confirm diagnosis of PCL injury
Treatment
- Non-surgical treatment:
- Most PCL injuries are grade 1 or 2 sprains that can heal on their own and do not require surgical repair
- Rest
- Ice
- Non-weight bearing until tolerable
- Physical therapy
- Surgical treatment:
- Arthroscopic tissue graft
