Posterior Cruciate Ligament injury or PCL Injury

Posterior Cruciate Ligament or PCL injury

Overview

PCL or posterior cruciate ligament is one of the major ligaments in the knee. When compared to the other part, ie, the anterior cruciate ligament, posterior cruciate is less susceptible to injuries. The posterior and anterior ligaments help to hold the knee together. Tear in any of the ligaments will cause swelling, pain and instability. The ligaments attach the bones one another. A posterior cruciate ligament injury causes less pain and discomforts when compared to that of an ACL injury. As the synovial covering helps the PCL to heal from an injury on its own, most PCL injuries can be treated non surgically. If the PCL injury takes place in combination with another ligament injury, it may require a surgical reconstruction.

What are the symptoms of PCL injury?

There can be mild signs and symptoms in certain cases, which may get worse with time. Some of the common signs and symptoms include:

Swelling
Pain
Instability

What are the indications for posterior cruciate ligament surgery?

PCL surgery is recommended if there is any sharp tear in the PCL combined with an ACL tear, MCL complex tear or posterior-lateral tear. Certain cases can be tackled with peel off or bone avulsion surgery. Reconstruction is indicated for those who show symptoms like severe pain and instability.

How is the procedure done?

There is a variety of graft types used for the PCL surgery. Quadriceps tendon with bone blocks, autogenous patellar or hamstring tendons etc, are usually used for grafting. Apart from that, Achilles tendon allografts or patellar tendon are also used. During the surgery, the main portion of the PCL, called the Antero lateral bundles are reconstructed. The surgery may be done as an open or arthroscopic basis. A tunnel is drilled on the site for attaching the new graft. The site is then prepared and graft is attached. After completing the procedure, the doctor will test the stability of the posterior cruciate ligament and close the incision.

What about the rehabilitation and recovery?

The patient will be suggested to take full rest for 2-4 weeks after an isolated PCL reconstruction. If it was a multi ligament reconstruction, the patient will be placed in a continuous passive motion machine. It is to regain the range of motion. The patient may need to use an immobilizer for 1 day after the surgery. Weight bearing is allowed only after 8 weeks from the surgery. The doctor may suggest more active rehabilitation programs after that.

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