Posterior Cruciate Ligament Tears

A posterior cruciate ligament (PCL) tear is a knee injury that occurs when the PCL, one of the major ligaments in the knee, is stretched or torn. The PCL is a strong band of tissue that connects the femur (thighbone) to the tibia (shinbone) within the knee joint. Its primary function is to prevent excessive backward movement of the tibia in relation to the femur. PCL tears can happen due to various mechanisms, with the most common being:

1. Trauma: A direct blow to the front of the knee while it is bent, such as in a car accident or during sports activities, can cause the PCL to tear. This is often referred to as a “dashboard injury” because it can occur when the knee hits the dashboard during a car accident.
2. Sports Injuries: Athletes, particularly those who play contact sports like football or soccer, may sustain PCL tears from tackles or collisions.
3. Hyperextension: When the knee is forcefully hyperextended, meaning it is straightened beyond its normal range of motion, it can result in a PCL tear.
4. Non-contact Injuries: In some cases, PCL tears can occur without direct trauma, usually in situations where there is a sudden change in direction or deceleration while the knee is in a partially bent position.

Treatment of a PCL tear typically depends on the severity of the injury and the individual’s activity level. Treatment options include:

1. Conservative (Non-Surgical) Management:
   – Rest: Avoiding activities that aggravate the injury and allowing time for natural healing.
   – Physical Therapy: Strengthening the muscles around the knee joint can help stabilize it.
   – Bracing: Wearing a knee brace to limit excessive movement and provide support.  A splint placed behind the tibia to hold the tibia reduced to the femur can aid in healing the posterior cruciate ligament at the correct length.  
   – Pain Management: Over-the-counter or prescription pain medications may be used to manage pain and inflammation.
2. Surgical Intervention:
   – Surgery is typically considered for more severe PCL tears or when other knee ligaments are also injured.
   – PCL Reconstruction: During surgery, the torn PCL may be repaired or reconstructed using graft tissue (often taken from the patient’s own body or a donor source).
   – Rehabilitation: After surgery, a structured rehabilitation program is essential to regain strength, stability, and range of motion in the knee.

The choice between conservative management and surgery is based on various factors, including the patient’s age, activity level, and the extent of the PCL injury. It’s essential to consult with an orthopedic specialist with experience treating this injury and doing this surgery for a successful outcome.  At Total Orthopedics and Sports Medicine we have orthopedic surgeons with vast experience in treating PCL tears successfully conservatively as well as with surgery.