ABOUT
The ligament located on the back and middle of the knee is known as the posterior cruciate ligament, or the PCL. It is one of several ligaments that connect the femur (thighbone) to the tibia (shinbone). The posterior cruciate ligament is the strongest ligament of the knee and thus, it is injured less often accounting for about 3-37% of all knee injuries.
A posterior cruciate ligament injury is often caused by a powerful force for example, a dashboard injury in a car accident or a hockey player hitting the goalpost etc.
SYMPTOMS AND INVESTIGATIONS
Unlike ACL injuries that present with giving way injury PCL injuries present usually with anterior knee pain and difficulty in full knee bending and squatting.
MRI and stress x-rays will be necessary for diagnosis
TREATMENT
Grade 1/Grade 2 tears with minimal laxity & sag on clinical examination can be treated conservatively.
Significant laxity (grade 3 laxity) & posterior sag or associated injury to other structures like the posterolateral corner(PLC) warrants surgery. However in an acute setting it is recommended to wait at least for a period of 2 weeks prior to surgery for the swelling to subside for improving knee movements before surgery.
Surgery will be done using arthroscopy(Keyhole surgery) & reconstruction will be done using grafts from both the knees.
Figure: Pictorial illustration of PCl tear
Post-operative rehabilitation :
Post-surgery non weight bearing mobilisation using a walker with a posterior knee supporting brace will be continued for 6 weeks while gradual knee bending can be resumed at 3 weeks. Then, Partial weight bearing continued for 2-3 weeks and from 8th week/2months full weight weight bearing walking advised. Sports and Squatting allowed after 6-7 months of exercise program.