PCL Tear

Posterior Cruciate Ligament (PCL) Injury

Posterior cruciate ligament (PCL) runs along the back of your knee and connects your thighbone to the top of your lower leg bone. PCL Ligament keeps your bones in place and helps your knee move smoothly. When the PCL is sprained or torn, it’s called a posterior cruciate ligament injury. People with a PCL injury will have pain, swelling and other symptoms

Who are at risk for PCL injury ?

Posterior cruciate ligament injuries are common among skiers and athletes who play baseball, football, wrestling or Dash board injury following road traffic accident.

How common are posterior cruciate ligament injuries?

Posterior cruciate ligament injuries are far less common than ACL. In fact, PCL injuries accounts for less than 20% of all knee ligament injuries. Most commonly, PCL tears occur with other ligament injuries. Isolated PCL tears are even less common.

A PCL injury can cause mild, moderate or severe damage.

Healthcare providers grade posterior cruciate ligament injuries in four different categories depending on MRI scan

Grade I

A partial tear is present in the ligament.

Grade II

There’s a partial tear and the ligament feels loose.

Grade Ill

The ligament is completely torn and the knee is unstable.

Grade IV

The PCL is injured along with another knee ligament is damaged.

Can you walk with a PCL injury?

In partial PCL tears, people may still be able to walk and their symptoms may be less noticeable. However, after complete PCL tear people have severe difficulty walking and some even can’t weight bear and tends to fall down.

Causes of PCL Tears

PCL injuries usually occur with severe knee trauma. You may develop a problem with your PCL if you:

Fall onto a bent knee.
Hit hard on the front of your knee (dashboard injuries in a motor vehicle accident).
Bend your knee too far backward.
Following Dislocation of knee joint.
Land improperly after a jump.

Symptoms of PCL Tear

Diagnosis and Tests

How is a posterior cruciate ligament injury diagnosed?

Doctor will examine your knee, check your range of motion and ask about your symptoms.

Special Tests to Diagnose PCL tear :

They may also request imaging tests to determine the extent of damage.
These tests may include:

Management and Treatment

How is a posterior cruciate ligament injury treated?

It depends on the severity of your PCL injury.
Common posterior cruciate ligament treatments include:

Crutches/ Walker : Use of walker or crutches to limit how much weight you put on your knee.
Knee brace: Long knee immobilser application so as to stabilise knee joint.
Physical therapy: Exercises can help strengthen and stabilize your knee.
Surgery: If PCL injury is severe, like in complete PCL tear or in partial tear who complaints of knee buckling (loss of knee balance while walking) surgery may be necessary for full rehabilitation.
In most cases, knee arthroscopy is performed to reconstruct your ligament. This procedure is less invasive compared to traditional surgical methods.

Complications following PCL surgery

Though complications are rare, there are certain risks associated with knee arthroscopy.

These include:

How long does a PCL injury take to heal?

Recovery time can vary from person to person. After an Arthroscopic surgery to repair or reconstruct PCL, recovery could take about six to nine months.

How can you manage symptoms at home?

If you’ve injured your PCL, there are ways to ease discomfort and promote healing.

Recommendations include:

Rest: Avoid any activity that places unnecessary stress on your knee.
Ice: Apply a cold compress to the knee for 15 minutes, four times a day.
Compression: Wrapping your knee in an elastic bandage helps reduce swelling.
Elevation: Prop your leg up on a pillow so it’s above the level of your heart.
Pain relievers: Take non-steroidal anti-inflammatory drugs (NSAIDs) to ease pain and swelling.

Outlook / Prognosis

What can I expect if I have a posterior cruciate ligament injury?

If your PCL injury is minor, you may heal without any surgery and with out any complications.

If the ligament sustained severe damage, your knee could become weak and prone to re-injury unless you have surgery.

People who undergo PCL surgery enjoy improved stability and mobility following recovery.

When can I go back to work or sports?

If you have a sedentary office job, you’ll be able to return to work rather quickly with in few days following surgery. However, if you have a job that requires physical exertion, such as lifting heavy weight, athletes or high level contact sportsman, then you have to give rest to knee joint for optimal healing of ligament to bone before one return to aggressive sports.

How can you prevent posterior cruciate ligament injuries?

PCL injury is usually high velocity injury, so It can be difficult to prevent PCL injuries altogether.

However, there are few things one can do to reduce your risk:

Stretch before physical activities to keep your knee joints healthy.
Use proper techniques while walking or running.
Use right shoes and proper turf and caution while playing sports.

When should you consult Sports injuries doctor for a posterior cruciate ligament injury?

Prompt medical attention is necessary after a serious PCL injury.

You should contact your healthcare provider if:

You have pain or swelling.
You feel like your knee is unstable.
Your foot feels numb.
Your leg or foot changes color or feels cold.

If you are exhibiting any of these symptoms, seek care immediately.

Final Note

Although PCL injuries can be painful and debilitating, they can be treated successfully with proper care. Neglecting PCL injuries can lead to cartilage and meniscus damage further preponing knee osteoarthritis.

Its wise to listen to your healthcare provider’s recommendations in order to speed up your recovery so you can return to normal life.

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