• Posterior Cruciate Ligament Injury

    (PCL Tear)

    Definition

    The posterior cruciate ligament (PCL) is connective tissue located within the knee. The PCL connects the thighbone to the shinbone. This connection keeps the shinbone from moving too far backward, stabilizing the knee.
    Posterior Cruciate Ligament
    si55550644 97870 1 Posterior Cruciate Ligament
    Copyright © Nucleus Medical Media, Inc.

    Causes

    The PCL ligament can become strained or torn when a strong force is applied to it. This force can occur during sports or other high-stress activity.

    Risk Factors

    Factors that may increase your chance of injuring the PCL include:
    • Sports injury
    • Motor vehicle accident
    • Fall on a bent knee
    • Strong force to the leg immediately below the kneecap
    • Knee dislocation

    Symptoms

    A PCL tear may cause:
    • Pain and swelling in the knee
    • Soreness in the area behind the knee
    • Weakness or instability in the knee
    • Difficulty walking
    • Pain when moving the knee

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Images may need to be taken of the internal structure of your knee. This can be done with:
    Ligament sprains are graded according to their severity:
    • Grade 1—mild ligament damage
    • Grade 2—partial tearing of the ligament
    • Grade 3—complete tearing of the ligament

    Treatment

    Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

    Supportive Care

    Your ligament will need time to heal. RICE is often the main part of treatment:
    • Rest—Activities may need to be restricted at first. Normal activities will be gradually reintroduced.
    • Ice—Ice therapy may help relieve swelling. Heat or cold may be recommended throughout recovery if they provide benefits.
    • Compression—Used for a limited time, compression bandages can provide gentle pressure to help move fluids out of the area.
    • Elevation—Keeping the area elevated can help fluids drain out or prevent fluids from building up.
    Your doctor may recommend a knee brace to stabilize the knee, and crutches to keep extra weight off your leg.
    Prescription or over-the-counter medications may be advised to reduce pain.

    Physical Therapy

    A physical therapist will assess your knee. An exercise program will be created to help recovery and to strengthen the muscles.

    Surgery

    Surgery may be needed to fully restore function of the knee. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and associated factors.

    Prevention

    Some steps that may help decrease your chance of getting a PCL injury include:
    • Protect your knees by doing regular strengthening exercises for your thighs.
    • Maintain proper technique when exercising or playing sports.

    RESOURCES

    American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

    OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;(6):CD007402.

    Knee sprains and meniscal injuries. Merck Manual for Health Care Professionals. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/fractures%5Fdislocations%5Fand%5Fsprains/knee%5Fsprains%5Fand%5Fmeniscal%5Finjuries.html. Accessed March 11, 2016.

    Ligament injuries to the knee. John Hopkins Medicine website. Available at. http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic%5Fdisorders/ligament%5Finjuries%5Fto%5Fthe%5Fknee%5F85,P00926/. Accessed March 11, 2016.

    Posterior cruciate ligament injuries. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00420. Updated February 2009. Accessed March 11, 2016.

    10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

    Revision Information

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