PCL which stands for posterior cruciate ligament positions within the knee joint parallel to the anterior cruciate ligament (ACL), binding the femur (thigh bone) to the tibia (shinbone). Reports suggest that PCL tears don’t happen to people as frequently as compared to ACL injuries. But the answer to the question of- how do PCL injuries occur? is very simple. It arises due to abnormal movements such as twisting, sudden falls, dashboard injury or head-on impacts to the knee during tough sports. We will discuss how the condition affects us and what entails a proper PCL injuries knee treatment; but first, let us go through the knee anatomy a bit. This will help you understand the medical condition in depth, and allow you to take action for yourself or suggest someone you know, who is suffering from the same.
Structural Insights
The knee joint- It’s a complex structure altogether where three significant bones i.e. the kneecap, tibia, and femur play a crucial role every day to help you make the basic movements when you walk. The patella a.k.a kneecap, acts within a trough at the end of the femur. If we look at the overall architecture, you will notice that the robust muscles in the thigh, especially the quadriceps at the front and hamstrings at the rear, provide balance and strength to the knee.
The knee is balanced by four substantial ligaments, two of which we have already discussed earlier i.e. ACL and PCL. Now the other two are – the medial one (MCL) and the lateral collateral ligament (LCL). The PCL and ACL traverse within the knee joint, working simultaneously to keep the joint balanced and refrain from strenuous forward and backward movement. They also manage the rotational motion of the tibia, which is crucial for actions like running, skating, or driving.
Symptoms and how it can affect your daily life
In the initial days, the symptoms can be very ambiguous, leading people unaware of the injury until the situation degrades and cause pain over the course of time. Typical symptoms include-
- Minimum to moderate knee pain.
- Exponential swelling and soreness around the knee.
- Feeling deep pain during regular activities like squatting, running, kneeling, or pacing up and down the stairs.
- Uneasiness during a stroll or frequent limping.
- A tingle of disbalance in the knee, as if it might yield soon.
Diagnosis of PCL injury
To diagnose PCL injuries knee, your healthcare provider should suggest a few steps:
- Any standard Sports injuries specialist should start asking about your history i.e. when you injured yourself and how it happened. If the doctor that you are about to consult is from shoulderandkneeclinic.com, then you might be asked additional questions like-
- If your knee were straight, twisted, or bent after the accident
- How gradual was the pain right after the incident, and
- If you have faced the symptoms since the accident
- The next step would be a physical examination. In this, you would be asked by your doctor to lie on your back with your knee bent. The doctor then examines your knee and presses against your upper shin. During this entire action, if abnormal movement of your knee is identified, it may suggest a PCL injury.
- Imaging- Another basic step towards a fool proof diagnosis is imaging. Generally, X-rays might be suggested by your doctor to identify any signs of damage to your knee. Moreover, sometimes an MRI scan is also suggested to obtain a clear image of the PCL injury.
Treatment
There happen to be non-surgical treatments for PCL injuries and these are only feasible when it is-
- Grade I or II injuries and doesn’t involve any other knee ligaments.
- Low activity level of the individual
Some individuals need to go through some exercises as advised by their physicians. This only helps to regain the leg muscles around the knee. A rehabilitation session is also recommended whether the patient goes through surgery or not.
When neither home remedies nor non-surgical treatments yield results, your Sports injuries specialist might suggest you for a surgical procedure. This is typically the scenario when you have hurt other ligaments in your knee apart from the PCL. Our doctors would clearly communicate with you whether surgery would be the ultimate solution or not.
So, the general criteria that draw the line towards surgery are-
- A condition where PCL injuries include loose or broken pieces of bone
- Injuries where more than one ligament is involved
- Acute PCL disbalances that causes symptoms, especially in athletes
Generally PCL is not repaired except in cases of bony avulsion of the PCL where it has come poff with a piece of bone from the tibia. The reason behind refraining from utilizing the old one is that it doesn’t heal properly in the long run. Instead, the doctor will reconstruct the PCL and incorporate the old tissue in the reconstruction
The subsequent ligament may be substituted with-
Piece of tendon extracted from other parts of your body, such as the back of your Bone patella tendon or thigh
This is what is known as an arthroscopic procedure in medical terms. It also involves certain tools and camera insertion through precise cuts around your knee. But you should know that this procedure is the ultimate solution to heal your PCL injury in no time. Another advantage is that it doesn’t leave scars as grave as other kinds of surgeries.
Post-surgery, you might need around 4-5 months for a complete rehabilitation period.
Now that you know what a PCL injury entails, you can decide on your own to proceed with diagnosis or further steps. Don’t forget to consult with an experienced Sports injuries specialist before making any major decision. Reach out to us at shoulderandkneeclinic.com to book an appointment with our most experienced doctors- known for their expertise and numerous successful procedures throughout their profession.