What is the PCL?
The posterior cruciate ligament (PCL) is a central stabilizing ligament in the middle of the knee. The PCL is located just behind the ACL. This ligament connects between the thigh bone (femur) and the shin bone (tibia). The PCL helps prevent the shin bone from moving behind the thigh bone.
Mechanism of injury
Injuries to the PCL normally are the result of a high force that pushes the shin bone backward in relation to the thigh bone. These are not as common as ACL tears. This can occur in a sporting injury with either a direct fall onto the shin bone with the knee bent or if another player strikes the front of the shin bone or even a twisting injury. PCL injuries can also occur in other traumatic injuries such as hitting your knee directly on the dashboard in a car crash.
Diagnosis and Symptoms
Following a direct blow to the shin bone with the knee in a bent position, an individual may experience swelling, pain, decreased knee range of motion and difficulty walking. These injuries can be diagnosed on clinical exam with the shin bone sagging backwards in relation to the thigh bone. X-rays are an important aspect of the initial evaluation to rule out an avulsion fracture (pulling off a piece of bone). In some circumstances, advanced imaging, including MRI and CT scan, may be required but is not always necessary.
Treatment for PCL sprain/tear
PCL injuries rarely happen in isolation but usually occur with another ligament or meniscus injury. These high energy injuries commonly can be treated without surgery. The PCL is not necessary to regain adequate function and to even participate in high level sports once healed. The initial non-operative treatment includes rest, icing, anti-inflammatories and possible bracing. After initial improvement in symptoms, a dedicated physical therapy (PT) program is recommended. PT will focus on retraining of the thigh muscles, increasing motion of the knee, and ultimately, a gradual progression of activities. Some individuals may require surgical management and are reserved for those with recurrent instability of the knee and those seeking to return to a high-level sport. Regardless, non-surgical and surgical treatments require a dedicated physical therapy program and recovery is a lengthy process.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.org/en/diseases–conditions/posterior-cruciate-ligament-injuries