Posterior Cruciate Ligament Tear

Posterior Cruciate Ligament (PCL) is a thick structure which is present in the backside of the knee connecting the thighbone to the shinbone, there by stabilizing the knee joint. It prevents the shin bone from displacing backwards during different activities. The PCL is generally larger and stronger than the Anterior Cruciate Ligament. Even then, the PCL can get damaged due to trauma or injury (direct or indirect), which can cause disability to the knee.

Normal Posterior Cruciate Ligament (PCL)

Torn Posterior Cruciate Ligament (PCL)

Causes of PCL Tear:

PCL can get injured for different causes.

  • A motor accident, where the knee gets a hit from the front against the dashboard.
  • Falling down with a bent knee or a direct collision during sports.
  • Landing in an incorrect manner while jumping.

Depending on the severity PCL tears has been classified as:

  • Grade I – Less severe partial tear of the PCL.
  • Grade II –More severe partial tear of the PCL.
  • Grade III – Complete PCL tear
  • Grade IV – Multi Ligament injury involving the PCL.

PCL Tear by direct Hit during accidental fall

Dashboard injury causing PCL tear

 

Symptoms of PCL Tear:

  • There may be a “popping” sound, thud or a snap which can be felt at the time of injury.
  • Knee pain with or without swelling.
  • There is a discomfort during brisk walking or stair climbing leading to lethargy and pain in the front of the knee
  • In due course of time, PCL tear can lead to arthritis of the knee leading to constant pain and disability.
  • Giving way feel when there is associated ligament tear.

Diagnosis of PCL Tear:

While physical examination can lead to the diagnosis of PCL tear, confirmation is usually by MRI scanning.

MRI showing PCL Tear

Treatment of PCLTear:

Treatment for PCL tear includes:

  • Complete rest of the knee
  • Elevation of the knee to avoid swelling.
  • Using Ice packs to give relief to the pain and reduce the swelling.
  • Being careful and protecting the knee from further injury by using a protective knee brace.
  • Pain relieving medicine

Key Hole Technique for PCL reconstruction surgery

Grade I and Grade II PCL tears do not require surgery. After protected knee brace for 3 to 6 weeks they have to start undergo physiotherapy and can gradually go back to normal activity.

However Grade III and IV PCL tears need surgical intervention. With Modern technology and improvisation in surgical techniques, these injuries are routinely treated by Key-Hole technology without opening the joint. There are multiple advantages to this technique such as a) less blood loss, b) less pain, c) early recovery, d) less tissue damage, e) lesser chance of infection, f) more cosmetic,etc. After surgery patient has to undergo physiotherapy for three to six months and after which he or she will be able to do all activities which they were doing before the injury.

 

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