Posterior Cruciate Ligament (PCL) tear

The PCL is shown in red in this picture.

The posterior cruciate ligament is also located deep within the knee joint. Like the ACL it attaches to the tibia to the femur, but stops the lower leg (tibia) sliding backwards and rotating relative to the upper leg (femur).

Injuries to the PCL are relatively rare accounting for approximately 1.5% of soft tissue knee injuries. This is in part due to its greater strength compared to the ACL.

The commonest way of injuring the PCL is by a direct blow to the front of the knee, occurring whilst the knee is in a flexed position. This can occur in impact sports or in a car crash if the dashboard impacts against the upper part of the tibia (shin bone). Other mechanisms of injury include hyperflexion (knee bends an abnormal amount), hyperextension (knee straightens too much) or rotational injuries. With these mechanisms there is often damage to some of the other knee ligaments.

Symptoms of a PCL injury are variable but often include some pain and swelling in the back of the knee or calf. Knowing how the injury happened, and performing a clinical examination can help to make the diagnosis. An MRI scan should ultimately be performed as it has the greatest accuracy for diagnosing PCL rupture and associated complications.

Management of PCL tears is largely non-operative. This comprises of a combination of pain relief, ice application, physiotherapy and a phased exercise programme designed by a physiotherapist. More severe injuries may benefit from using a brace initially. Rehabilitation takes approximately 12 weeks depending on the severity of the injury.

Results of non-operative management are often very good, There may be some laxity (slackness) of the knee but after rehabilitation, around half of individuals return to sport at an equivalent or higher level to their pre-injury state. If you have an isolated PCL tear surgery is not usually needed. However, it might be beneficial if you have a PCL tear alongside other knee ligament injuries, or if you have significant rotational instability.

Posterior Cruciate Ligament Reconstruction

The video below shows a detailed explanation of the causes and presentation of Posterior Cruciate Ligament Reconstruction. They show a basic outline of the procedures used by Amir Qureshi and after care required in order that you, the patient, may recover to your full fitness once again.