What is a posterior cruciate ligament injury (PCL)?
The cruciate ligaments are found in the middle of your knee joint, forming an “X” configuration as they cross each other to connect the thigh bone (femur) and the shin bone (tibia). The posterior cruciate ligament (PCL) is found at the back of the knee and prevents the tibia from sliding too far backwards.
The PCL is a thick, strong ligament requiring a powerful force to injure it. Therefore, it is not commonly injured in isolation. Injury mechanisms include landing on a bent knee, a direct blow to the front of the knee and over-straightening (hyperextension) of the knee. Unlike anterior cruciate ligament injuries, partial PCL tears are commonly seen. A complete PCL rupture is a serious injury often associated with damage to other structures.
What are the symptoms of PCL injury?
At the time of PCL injury, there is deep pain and rapid onset of swelling make it very difficult to walk. Once the pain and swelling have resolved your knee can feel unstable and may give way. Sometimes the symptoms are quite subtle, particularly with partial tears.
How is a PCL injury diagnosed?
The symptoms and a careful examination will usually suggest the diagnosis. An x-ray can be useful, but an MRI scan is the investigation of choice.
How is it treated?
Fortunately, most people with isolated PCL injuries don’t have knee surgical intervention. Injuries heal well and individuals can eventually return to sports without problems. Initial treatment is aimed at managing the pain and swelling through rest, analgesic/anti-inflammatory medication, ice therapy and crutches may be used to help mobility. A special knee brace, designed specifically for PCL injuries, helps prevent further instability and restores the relationship between the tibia and femur to promote PCL healing. As the pain and swelling subside, specific rehabilitation is started to restore motion, function and strength to your knee and leg.
Surgery is recommended in severe injuries involving multiple knee ligaments including the PCL. The torn ligament is replaced with a tissue graft. This can be taken from another part of your knee or leg (autograft) or from a human cadaver donor (allograft). In the case of multiple ligament injuries, a combination of both is often required. The advantages and disadvantages of each option will be discussed by the surgeon to choose the best graft options for each individual. It can take several months for the graft to heal to your bone.
Physiotherapy and rehabilitation play a crucial role whether you have surgery or not. Full recovery can take up to a year, and sometimes longer with multiple ligament injuries. Although at times you may feel frustrated, commitment to therapy is the most important factor in getting back to the activities you enjoy.
If you or someone you know has suffered an injury or is experiencing pain across their lower limbs or difficulty with mobility and would like a consultant-led review, please contact us. Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.
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Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.
KNEE CONDITIONS
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KNEE TREATMENTS
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our KNEE SURGEONS
The Knee Service at Grosvenor Orthopaedic Partners is led by Mr Luke Jones and Mr Chethan Jayadev, both Oxford PhD educated knee surgeons with London Teaching Hospital NHS consultant posts. They provide a comprehensive range of knee procedures as part of a multidisciplinary team of healthcare professionals including highly specialised physiotherapists, all committed to returning you to optimal function.
Our team are well placed to manage and treat a diverse range of knee problems utilising cutting edge diagnostic technology and treatment approaches, both surgical and conservative. Below is an overview of some of the knee conditions we treat but for a more thorough understanding please contact our team here
MR LUKE JONES
Consultant Orthopaedic Knee Surgeon
MR CHETHAN JAYADEV
Consultant Orthopaedic Knee Surgeon
MR MARK WEBB
Consultant Orthopaedic Knee Surgeon
What some of our patients say
Mrs EL
Thank you for taking great care of me throughout the whole operation process! My recovery has been much faster than anticipated and I am pain free after such a long time!