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Posterior Cruciate Ligament Tear

Posterior Cruciate Ligament or PCL is one of the ligaments present in the knee joint. It connects the thigh bone or femur to the shin bone (tibia). Its main function is to prevent the shin bone from displacing backwards during an activity.
The PCL tear is a less common knee injury that usually occurs from a trauma to front of the knee, especially when the knee is bent. The injuries can be caused during a vehicle accident or a sport. Partial PCL tears have a tendency to heal on their own.

Treatment of posterior cruciate ligaments , depends on the location of tear, severity of the injury ( grading of the tear )
PCL tears usually occur in the following different levels:

  • Mild (Grade 1) level and
  • Moderate (Grade 2) level usually heals well on its own and doesn’t need a surgery.
  • Severe (Grade 3) level and other injuries to the ligaments require surgeries to rectify the conditions. A severe PCL injury, if not treated by surgery, can lead to an early onset of arthritis of the knee joint.
  • PCL Avulsions needs arthroscopic fixation

Non-Surgical Treatment
The mild and moderate grades of PCL tears can heal quite well by treating them with non-surgical methods that include:

  • RICE
    The doctor would suggest resting the knee and putting ice on it. Sometimes, the knee might need gentle compression and be kept in an elevated position for faster healing.
  • Immobilization
    The doctor might put a brace on the knee to prevent it from moving. The patient have to walk on crutches to prevent putting weight on the leg.
  • Physical Therapy
    The doctor will recommend physical therapy when the swelling goes down. The physical therapist will prescribe certain exercises to restore function to the knee and strengthen the muscles to support the knee, especially the quadriceps.

Surgical Treatment
The doctor might recommend surgery if there are combined injuries or multiple PCL tears. The surgery is usually performed on complete PCL tears only after the swelling subsides and the motion of the knee is restored, which normally takes a few weeks.
This procedure is called Ligament Reconstruction replacing the torn PCL with a new ligament, which is usually a graft taken from the hamstring, quadriceps, or the allograft Achilles tendon. This is done through Arthroscopy or keyhole surgery, where small incisions are made near the knee and a tiny camera called the arthroscope is used to view the extent of the injury and also guide the small specialized instruments to perform the surgery.

Post – Surgery
The recovery of the patient after surgery might depend upon the severity of the injury. The combined injuries usually have a slow recovery time but most patients have reported great improvement. The patient might take around 3 to 6 months for a full recovery.
The doctor might recommend physical therapy for strengthening the knee and restoring the motion of the knee.

Authored by Dr Banarji B.H - Shoulder Surgeon, Bangalore

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