Posterior Cruciate Ligament (PCL) Injuries

What is the PCL?

The PCL prevents the tibia from moving backward relative to the femur and is stronger than the ACL. Injuries usually occur from high-energy trauma like car accidents or falls onto a bent knee.

Symptoms

  • Mild pain or instability compared to ACL injuries.
  • Swelling localized at the back of the knee.
  • Difficulty walking or descending stairs.

Diagnosis

  1. Physical Examination:
    • Posterior Drawer Test: Detects backward displacement of the tibia.
    • Posterior Sag Sign: Observes sagging of the tibia in a flexed knee.
  2. Imaging:
    • MRI: Confirms the grade of PCL injury.
    • Stress X-Rays: To measure tibial displacement.

Treatment

  • Non-Surgical (Grade I or II injuries):
    • Physical therapy focusing on quadriceps strengthening to compensate for instability.
    • Knee bracing to protect during healing.
  • Surgical (Grade III or combined injuries):
    • PCL Reconstruction using grafts.

Rehabilitation

  • Longer recovery than ACL injuries due to slower healing.
  • Focus on gradual strengthening without overloading the posterior knee.