PCL (LIGAMENT) TEAR

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Posterior cruciate ligament (PCL) injury happens far less often than does injury to the knee's more vulnerable counterpart, the anterior cruciate ligament (ACL). The posterior cruciate ligament and ACL connect your thighbone (femur) to your shinbone (tibia). If either ligament is torn, it might cause pain, swelling and a feeling of instability.

Ligaments are strong bands of tissue that attach one bone to another. The cruciate (KROO-she-ate) ligaments connect the thighbone (femur) to the shinbone (tibia). The anterior and posterior cruciate ligaments form an "X" in the center of the knee.

Although a posterior cruciate ligament injury generally causes less pain, disability and knee instability than does an ACL tear, it can still sideline you for several weeks or months.

KNEE LIGAMENTS ANATOMY

DISEASE EXPLAINED

SYMPTOMS

PAIN.
Mild to moderate pain in the knee can cause a slight limp or difficulty walking.

SWELLING.
Knee swelling occurs rapidly, within hours of the injury.

INSTABILITY.
Your knee might feel loose, as if it's going to give way.

If there are no associated injuries to other parts of your knee, the signs and symptoms of a posterior cruciate ligament injury can be so mild that you might not notice that anything's wrong. Over time, the pain might worsen and your knee might feel more unstable. If other parts of your knee have also been injured, your signs and symptoms will likely be more severe.

CAUSES

The posterior cruciate ligament can tear if your shinbone is hit hard just below the knee or if you fall on a bent knee. These injuries are most common during:

MOTOR VEHICLE ACCIDENTS.
A "dashboard injury" occurs when the driver's or passenger's bent knee slams against the dashboard, pushing in the shinbone just below the knee and causing the posterior cruciate ligament to tear.

CONTACT SPORTS.
Athletes in sports such as football and soccer can tear their posterior cruciate ligament when they fall on a bent knee with their foot pointed down. The shinbone hits the ground first and it moves backward. Being tackled when your knee is bent also can cause this injury.

TREATMENT

TREATMENT OPTIONS

Treatment depends on the extent of your injury and whether it just happened or if you've had it for a while. In most cases, surgery isn't required.

MEDICATIONS
Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), can help relieve pain and reduce swelling.

THERAPY
A physical therapist can teach you exercises that will help make your knee stronger and improve its function and stability. You may also need a knee brace or crutches during your rehabilitation.

SURGERY
If your injury is severe — especially if it's combined with other torn knee ligaments, cartilage damage or a broken bone — you might need surgery to reconstruct the ligament. Surgery might also be considered if you have persistent episodes of knee instability despite appropriate rehabilitation.

This surgery usually can be performed arthroscopically by inserting a fiber-optic camera and long, slender surgical tools through several small incisions around the knee.

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