PCL Tear Specialist Singapore
Dr. Bryan Tan
FRCS Ed (Orth)
A PCL injury happens when the ligament connecting the shinbone and thighbone is ruptured. An injury to the posterior cruciate ligament (PCL) requires a powerful force as it is bigger and stronger compared to the anterior cruciate ligament (ACL). Damage to this ligament may result in severe twisting or contact injury. Understanding your symptoms and seeking immediate medical attention are vital to prevent further complications.
Dr. Bryan TanOrthopaedic Surgeon
Sports have always played a big part in Dr Bryan’s life. His interest in sports and varied sporting activities give him a deep understanding of sports injuries and the mindset of an athlete.
The condition often develops gradually over time and is difficult to detect. This painful condition affects 2-5% of the general population.
Dr Bryan Tan is a fellowship-trained orthopaedic surgeon, based in Singapore. He completed 2 fellowships in Orthopaedic Sports, Shoulder and Elbow Surgery in Sydney, Australia and Nice, France. Prior to private practice, Dr Bryan was a consultant in the Division of Shoulder and Elbow Surgery in National University Hospital (NUH), Singapore. He is currently still a visiting consultant at NUH where he actively teaches medical students and young orthopaedic surgical trainees. In addition, he travels to regional countries to teach advanced arthroscopic surgical techniques.
Dr. Bryan has a special interest in keyhole surgery and performs most of his surgeries using advanced, modern keyhole surgical techniques. He regularly visits fellow surgeons from other countries to ensure his skills and knowledge are cutting edge.read full bio
What is a Posterior Cruciate Ligament (PCL) Injury?
The posterior cruciate ligament (PCL) is located behind the anterior cruciate ligament (ACL). It is responsible for connecting the thigh bone (femur) to the shinbone (tibia) in the middle of the knee. It is bigger and stronger than the anterior cruciate ligament but can be damaged by direct impact.
A posterior cruciate ligament tear or injury happens when the knee is bent, and the shin is abruptly thrust backwards by impact. This can be due to a sports injury, a tumble, or an automobile accident wherein the shin is jarred into the dashboard.
What Are The Different Categories of A PCL Tear?
PCL tears are categorised into four grades:
Posterior cruciate ligament injuries can be acute or chronic. An abrupt injury is the cause of acute PCL issues. A PCL injury that progresses over time leads to chronic posterior cruciate ligament issues.
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What Are The Symptoms Of A Posterior Cruciate Ligament (PCL) Injury?
Diagnosis Of A Posterior Cruciate Ligament (PCL) Injury
- Physical Examination
Your doctor may perform an in-depth examination of your symptoms and review your medical history to determine the cause of your injury.
- Imaging Tests
Imaging procedures such as x-ray, MRI, or bone scan may be recommended by your doctor to see if there is any broken bone and evaluate the grade and severity of the PCL tear.Contact clinic
Treatment Procedures for Posterior Cruciate Ligament (PCL) Injury
- PRICE. Majority of minor or sports-related injuries can be treated with the PRICE protocol. PRICE is the acronym for Protect, Rest, Ice, Compression, and Elevation.
- Protect. Protect your knee from further injury.
- Rest. Immediately stop engaging in the activity that injured you.
- Ice. Apply cold packs to reduce pain and swelling.
- Compression. Wear a stretchable compression bandage to prevent swelling.
- Elevation. When resting, lean back and elevate your leg above your heart to help minimise pain and swelling.
- Protect. Protect your knee from further injury.
- To lessen the aftermath effect of the trauma, the doctor may advise you to take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, or naproxen to reduce pain, swelling, and discomfort.
- You may undergo initial knee bracing to reduce discomfort while preventing posterior tibial displacement.
- The doctor may also advise you to use crutches to aid in restoring the strength of your quadriceps.
- You may be required to undergo physical therapy which includes muscle-strengthening exercises, such as quadriceps strengthening. It is best to avoid hamstring exercises as they might cause increased posterior translation.
Transtibial Posterior Cruciate Ligament Reconstruction
- If your posterior cruciate ligament has been pulled and separated from its anchor point, it can be reattached to the bone through surgical screws, pins, or sutures.
- Allograft may also be performed through tissue taken from a donor source (cadaver). The two key benefits of allograft are quicker initial recovery and less surgical morbidity.
- An autograft uses the patient’s tissue for reconstruction, thus, reducing the danger of rejection. The bone-patellar tendon-bone (BTB) graft, hamstrings, or quadriceps tendon are a few sources for a graft.
You may be instructed by your doctor to keep your knee fully extended for two to four weeks while wearing a knee brace. Your shin bone (tibia) should be supported by pillows or other devices for the first two months following surgery to prevent any posterior tibial subluxation or partial dislocation.
Rehabilitation and weight-bearing cannot begin until eight weeks have passed.
What Are The Causes of A Posterior Cruciate Ligament (PCL) Injury?
A posterior cruciate ligament is less common compared to other sports-related injuries. It only accounts for 20% of knee ligament injuries. Below are the causes of PCL injury:
Your Treatment Roadmap with Dr. Bryan
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With Dr. Bryan
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Initial Consultation & Diagnosis of your Condition
During your consultation, Dr. Bryan will evaluate your medical history and the pain you are experiencing. You may also ask Dr. Bryan any questions you may have about your condition.
Treatment & Follow Up Visits With Dr. Bryan
After your consultation with Dr. Bryan, our friendly clinic staff will assist you with your follow-up appointment, and provide you with instructions/information for any prescribed treatment plans from Dr. Bryan.
What are the Risk Factors of a Posterior Cruciate Ligament Injury?
Below are factors that may increase the risk of posterior cruciate ligament injury:
- Sports that require frequent shifts and pivots, such as basketball, soccer, and football
- Skiing and dancing
- Engaging in manual labour such as construction and landscaping, wherein squatting and heavy lifting are common tasks
- Multi-ligament knee injuries
- Age (older adults)
What is the difference between ACL and PCL?
Your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are crucial and integral components of your knee that support and stabilise its forward and backward mobility. Both ligaments cross each other to form an “X” as they join the femur (thighbone) to the tibia (shinbone). The PCL is less frequently injured and is stronger than the ACL.
Can my torn posterior cruciate ligament (PCL) heal on its own?
Through physical therapy and bracing, it is possible for a PCL tear to recover on its own. You may then be re-evaluated to determine the best course of action for your recovery. However, if it is severely torn or damaged, reconstruction or repair may be required.
How long does it take for me to recover from a torn PCL?
Most patients typically recover in as little as ten days if the injury is minor. Depending on the extent of your PCL repair surgery, rehabilitation may take six to nine months.
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