The posterior cruciate ligament (PCL) plays a crucial role in keeping your knee stable. Located at the back of the knee, it connects the femur (thigh bone) to the tibia (shin bone), preventing your shin from moving too far backward.
How Do PCL Injuries Happen?
PCL injuries often occur from a direct blow to the front of the knee while it’s bent—imagine hitting your knee against a car dashboard during an accident. It can also happen if you fall hard on a bent knee or hyperextend it violently.
Symptoms of a PCL Injury
Unlike ACL injuries, PCL injuries don’t usually cause severe swelling. You may feel stiffness, moderate swelling, or notice that your knee “gives way” occasionally. While the pain and swelling generally improve in a few weeks, the feeling of instability can persist.
Diagnosing a PCL Injury
A combination of physical exams and imaging tests can help diagnose a PCL injury. Specific tests like the posterior Lachman test or MRI scans are used to confirm the extent of the damage. Sometimes, more than one ligament can be injured, which may make your knee feel even more unstable.
Treatment Options for PCL Injuries
Nonsurgical Treatment
For less severe PCL injuries, nonsurgical options often work well. Initial treatment includes resting, using ice, and keeping the leg elevated to reduce pain and swelling. A brace and crutches can help with walking until the knee feels more stable. Rehabilitation exercises play a key role in helping you regain full movement and strengthen the knee.
Surgical Treatment
In cases where the PCL is injured alongside other ligaments, like the ACL or posterolateral corner (PLC), surgery may be required to restore knee stability. Surgery involves reconstructing the torn PCL, often using a tendon graft. The procedure is usually done arthroscopically, which means smaller incisions and a quicker recovery.
What to Expect After Surgery
After surgery, you’ll start using a continuous passive motion (CPM) machine to gently move your knee and prevent stiffness. A knee brace will protect the joint for up to six weeks, and crutches will help you walk for a few weeks. A personalized rehab program over four to six months is essential for rebuilding strength and stability.
Case Example
Consider this scenario: A young athlete injured his knee in a car accident, striking it against the dashboard. Initially, he experienced mild swelling and pain that improved over a few weeks. However, his knee often gave way when walking, and he couldn’t return to sports. An MRI revealed a torn PCL. After nonsurgical treatment failed to restore stability, he underwent arthroscopic surgery to reconstruct the PCL. With a tailored rehabilitation plan, he regained full function and returned to playing sports within six months.
Whether treated nonsurgically or with surgery, with the right care and rehabilitation, most patients recover well from a PCL injury and can return to their usual activities.