Posterior Cruciate Ligament Injury
Diagnosing PCL Problems
To diagnose a PCL injury, a doctor may take these steps:
History. Your doctor will ask what you were doing when the injury occurred, such as traveling in a car or playing a sport. He or she will also ask:
- If your knee was bent, straight, or twisted when it was injured
- How your knee felt after the injury
- If you've had any symptoms since you were injured
Physical examination. In a common test for PCL injuries, you lie on your back with your knee bent. Your doctor then examines your knee and presses against your upper shin. Abnormal knee movement during this test suggests a PCL injury.
You may also be checked with a device called an arthrometer. This presses against your leg to measure the ligament's tightness.
Your doctor may also ask you to walk. An abnormal walking motion may point to a PCL injury.
Imaging. X-rays can provide information about a PCL injury. They can detect pieces of bone that may have broken loose from the injury.
Magnetic resonance imaging (MRI) is a common way to create images of a PCL tear. An MRI can find the exact location of a tear.
Home Treatment of a Posterior Cruciate Ligament Injury
For initial treatment of a PCL injury, the approach known as PRICE may be helpful. This includes:
Protecting the knee from further injury
Resting the knee
Icing the knee for short periods with cold packs
Compressing the knee gently, such as with an elastic bandage
Elevating the knee
A pain-relieving medication may also be needed for knee pain.
Nonsurgical Treatment of Posterior Cruciate Ligament Injury
You can recover from some posterior cruciate ligament injuries without surgery.
Cases that may not require surgery include:
- Acute grade I or II injuries when no other knee ligaments are injured
- Newly diagnosed chronic injuries that only affect the PCL and aren't causing symptoms
Some people need to go through physical therapy after a PCL injury. This rehabilitation may be necessary with or without surgery.
Rehabilitation may include:
- Using crutches at first, then gradually walking with more weight on the knee
- Having a machine or therapist move your leg through its range of motion
- Temporarily wearing a knee brace for support
- Strengthening your thigh muscles to help make the knee more stable
- Walking or running in a pool or on a treadmill
- Specific training needed for a sport
Surgery for Posterior Cruciate Ligament Injury
Patients who may be more likely to need surgery include those who have:
- PCL injuries in which pieces of bone have torn off and become loose
- Injuries involving more than one ligament
- Chronic PCL looseness that causes symptoms, especially in athletes
If a piece of bone is torn off, a surgeon may fasten the bone back into place using a screw.
Surgery for a torn PCL requires replacing it with new tissue rather than stitching together the torn ligament. The ligament may be replaced with:
- Tissue from a deceased donor
- Piece of tendon moved from somewhere else in the body, such as the back of the thigh or heel
The operation is sometimes done as an "open" surgery. This requires a large incision in the knee.
A less-invasive option involves a tool called an arthroscope. The surgeon uses smaller incisions.