PCL tears usually occur in different levels. The mild (Grade 1) level and moderate (Grade 2) level PCL tears usually heals well on its own and doesn’t need a surgery. But the severe (Grade 3) level PCL tears and multiple ligament injuries require surgical treatment. A severe PCL injury, if not treated by surgery, can lead to an early onset of arthritis of the knee joint.
The surgery is performed on complete tears of ligaments and takes place after a few weeks, to allow for the swelling to subside and allow for motion of the knee. The procedure is called Ligament Reconstruction replacing the torn PCL with a new ligament, which is usually a graft taken from the hamstring.
Although there are multiple techniques for PCL reconstruction, we do arthroscopic PCL reconstruction without opening the knee joint, which is the most advanced and effective method for treating complete PCL tears.
The different types of grafts used in PCL reconstruction includes
a)Autograft – Tissues taken from patient is used as graft. The commonly used grafts are Hamstring and quadriceps tendons. Either of them can be used depending on the patient’s condition and severity of the injury.
b)Allograft – Graft from a donor is used for PCL reconstruction. Usually the Tendo-achillis with its bony attachment is used as a graft. Allografts are used when there is combines ligament injuries or when there is lack of options.
While numerous techniques have been described for PCL reconstruction we can broadly categories them into
1)Inlay technique done by open or closed method where a bone plug is used to fix the tibial end of the graft. This may be associated with knee cap pain or fracture if it is taken from the patient’s knee.Alternatively Achilles tendon graft can be used when there is paucity of graft.
2)The all inside technique done using arthroscopic method. Where the graft is fixed using two sling fixation devices.
Like for ACL reconstruction, after surgery the knee is protected by a knee brace and the patient is made to walk without putting weight in the operated leg using zimmer frame. After 2 weeks patient is made to walk full weight bearing without he help of the zimmer frame or the crutches. After 6 weeks patient is taken through several gym activities under the supervision of the physiotherapist. By 4 to 6 months patient will be able to do all the activities including elite sports without restrictions.
I met with an accident on Nov 8, 2017. My bone got smashed into 4 pieces heavily. I thought i wont reappear by walk, but with his auspicious treatment i just got completely cured in 2 months and i am on running on my leg now. He has returned back my normal life. Congrats and well done Sir.
My mother in law had her second knee replacement surgery and she is walking fine now,and Dr. Raj Kanna sir is very good at explaining the do's and don't s to the patient.
I had meniscus tear on my right knee. Thanks to Dr. Rajkanna. He explained the exact details of the status of injury, procedure to be done and do's & don't s after surgery. He didn't demand much as fees. I am feeling good like before the occurrance of injury. I would recommend him for Ortho related problems.