Posterior Cruciate Ligament (PCL) Tears
The posterior cruciate ligament (PCL) is stronger than the anterior cruciate ligament (ACL) and is injured less frequently. It arises from the posterior tibia (shin bone), travels superiorly and anteriorly, then inserts into the femur (thigh bone). The anterior and posterior cruciate ligaments form a cross shape in the middle of the joint.
- Keeps the knee stable when the leg is extended (knee is straight)
- Prevents hyperflexion of the knee
A tear causes the joint to lose stability. An injury to the PCL is rarely isolated, and usually a part of a complex injury with tears to the ACL and medial meniscus.
Signs and Symptoms
- Pain, swelling, weakness and often instability of the knee
- At the time of injury, you might hear a pop and your knee may give away
What causes an PCL tear?
- Direct impact to the tibia (lower leg)
- -usually when the knee is bent
- -e.g. collision, fall when the knee is bent
Initially treated with symptomatic management:
- Ice, elevation, physical therapy, and sometimes bracing
- -To reduce swelling, restore motion, strength and flexibility
If a patient remains symptomatic, surgical reconstruction of the ligament can be considered. This depends on severity of the injury and activity level of the individual.
Surgical Treatment: Knee Arthroscopy (PCL Reconstruction)
- Arthroscopic repair has the benefit of faster recovery compared to open techniques
- Not all repairs can be performed arthroscopically
- -Open technique may be required
- Torn ligament is replaced with healthy strong tissue or graft
- -From your own hamstring or patellar tendon (autograft) or another source including cadaveric tissue (allograft)
- Physical Therapy is an integral component to your recovery from surgery
- -Appropriate timing and progression is key to the outcome
- For further details on your rehabilitation, please see the Physical Therapy section in Patient Resources.
- Protecting your knee and maintaining strength is important after formal physical therapy has ended.
- A brace may be required for high-risk activities of sport involving twisting and turning motions.