Posterior Cruciate Ligament (PCL) Injury

What is a posterior cruciate ligament injury?

The knee joint contains two cruciate ligaments and two collateral ligaments. The posterior cruciate ligament (PCL), found behind (posterior to) the well-known anterior cruciate ligament (ACL) in the center of the knee, originates from the femur (thigh bone) and is attached to the back of the tibia (shin bone). Together, the PCL and ACL form an “X” within the knee joint and are collectively responsible for limiting the forward and backward movement of the tibia. Despite being the approximate size of one’s pinky finger, the PCL is a combination of two parts that integrate into the strongest of the four main knee ligaments. The powerful structure of the PCL lends to its ability to withstand large amounts of stress; however, a sizeable force to the anterior (front) knee and shin can consequently result in a PCL injury. While athletes who participate in contact sports are more likely to sustain a PCL injury, non-athletic individuals are also vulnerable to a PCL injury from a motor vehicle collision or a fall directly onto a bent knee. Dr. Joseph D. Lamplot, orthopedic knee specialist serving patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, has the knowledge and understanding, as well as substantial experience, in treating patients with a PCL injury.

Are there different degrees of a PCL injury?

A posterior cruciate ligament (PCL) injury is rated into one of three categories by the amount of damage to the ligament:

• Grade 1: A grade 1 PCL injury results in minimal ligament damage from the PCL being stretched or pulled.
• Grade 2: A grade 2 PCL injury occurs when the ligament is partially torn and can result in mild instability of the knee joint.
• Grade 3: A grade 3 PCL injury can result in moderate to severe knee joint instability from the PCL rupturing into two separate pieces.

What are the symptoms of a PCL injury?

Due to the significant amount of force required to damage the posterior cruciate ligament (PCL), a PCL injury is often accompanied by damage to other knee joint structures. The most common complaint among individuals with a suspected PCL injury is pain and swelling within the knee that is particularly noticeable when increasing speed on a run. Individuals may also experience mobility difficulties such as slowing down on a run, walking downstairs, and/or pivoting on the affected lower leg.

How is a PCL injury diagnosed?

It is strongly encouraged to consult an orthopedic knee specialist if a posterior cruciate ligament (PCL) injury is suspected, as it is rare that the PCL is the sole ligament to sustain damage. Dr. Lamplot begins by gathering a comprehensive medical history followed by a thorough physical examination. Dr. Lamplot may also request diagnostic imaging studies, such as x-rays and magnetic resonance imaging (MRI), to confirm the extent of damage to PCL and other structures within the knee joint.

What is the treatment for a PCL injury?

Non-surgical treatment:

In the event that no other knee joint structures sustained damage other than the posterior cruciate ligament (PCL), non-surgical therapies may be sufficient in treating a PCL injury. Ice, compression, and elevation along with bracing and physical therapy can effectively treat some PCL injuries.  Pain and inflammation associated with this injury can be managed with non-steroidal anti-inflammatory medications (NSAIDs). Participation in a physical therapy program that aims to strengthen and improve the functionality of the muscles surrounding the knee joint can be especially beneficial in healing a PCL injury. In certain circumstances, Dr. Lamplot can also administer an injection of a biologic such as PRP or an anti-inflammatory such as Cortisone or Toradol directly into the affected knee joint to make physical therapy more tolerable.

Surgical treatment:

Because the posterior cruciate ligament (PCL) is rarely the only ligament injured, surgical intervention to improve knee joint stability is often necessary. Patients that fail to respond to non-surgical therapies are good candidates for surgical reconstruction as well. The PCL is surgically reconstructed using a tendon graft harvested from either the patient (autograft) or donor (allograft). A minimally invasive surgical procedure is used to fix the tendon graft as close to the original PCL as possible using specialized surgical buttons and screws. Overlapping the tendon graft with the native PCL ensures the success of the new ligament after recovery.

PCL Injury Specialist