Posterior Cruciate Ligament Injuries

 

The posterior cruciate ligament (PCL) is the strongest ligament in the knee joint. Ligaments are thick, strong bands of tissue that connect bone to bone. The PCL runs along the back of the knee joint from the bottom of the thighbone (femur) to the top of the lower leg bone (tibia).

The PCL helps keep the knee joint stable, especially the back of the joint. An injury to the PCL could involve straining, spraining, or tearing any part of that ligament. The PCL is the least commonly injured ligament in the knee.

The main cause of PCL injury is severe trauma to the knee joint. Often, other ligaments in the knee are affected as well. One cause specific to PCL injury is hyperextension or over straightning of the knee. This can occur during athletic movements like jumping.

PCL injuries can also result from a blow to the knee while it is flexed, or bent. This includes landing hard during sports or a fall, or from a car accident.

Mechanism of PCL Injury

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Symptoms

 

Instability in the knee joint

Pain in the knee joint

Swelling in the knee

Stiffness in the joint

Difficulty walking

Management Treatment includes

 

Physical therapy or rehabilitation to strengthen and regain range of motion Surgery to repair the torn ligament

For those with major injuries who don’t have surgery, the joint will most likely remain unstable and be easily reinjured. You will be less able to do physical activities and pain could result from even minor activities. You may have to wear a brace to protect the joint during physical activity. Eventually Posterior cruciate deficient knees develop accelerated osteoarthritis.

For those who have surgery, the prognosis depends on the success of the surgery and of the associated injuries to the knee. Generally, you will have improved mobility and stability after the joint is repaired. You may need to wear a brace or limit physical activities in the future to help prevent re injuring the knee.

Surgery -PCL Reconstruction

 

The Ligament is reconstructed by a graft taken from your knee joint Hamstring tendon graft has a number of advantages and will usually be suggested to you as the graft of choice. It is also easier to rehabilitate after a hamstring graft.

The surgical procedure is  carried out arthroscopically (i.e. by “keyhole surgery”), although two small incisions are also needed, one on the inner side of the femur and the other (at the site of the hamstring tendon harvest) also on the inner aspect of the knee but over the tibia. Any other arthroscopic surgery (e.g. to the cartilage or menisci within the knee) can be performed at the same time.

The surgery for Posterior cruciate ligament done in expert hands leads to excellent results in the long run.

Rehablitation

The physiotherapy and bracing regime may vary from patient to patient, and in large part depends upon whether posterolateral corner or other ligament reconstruction has been necessary. The description below is the usual one employed but your Consultant will specifically outline the exact protocol to you prior to surgery.