PCL Tear Specialist Singapore
MBBS (SINGAPORE) MMED (ORTHO) FRCS ED (ORTH)
The posterior cruciate ligament (PCL) is one of the four major ligaments in the knee, situated at the back of the joint. It plays a crucial role in stabilising the knee, particularly in preventing the tibia (shinbone) from moving too far backwards relative to the femur (thighbone). The PCL works together with the anterior cruciate ligament (ACL) to maintain the knee’s stability during various activities, such as walking, running, and jumping.
However, when the PCL experiences sudden and excessive force or trauma, it can become stretched or torn, resulting in a PCL tear.
What Is A PCL Tear?
PCL tears are common knee injuries that can occur during sports or motor vehicular accidents.
The PCL is the counterpart to its more well-known parter, the ACL. It is a ligament that connects the femur (thigh bone) to the tibia (shin bone). Hard impacts to the flexed knee or hyper-extension to the knee can result in PCL tears.
What Causes PCL Tear?
Since the PCL’s primary function is to prevent the tibia from extending backwards, the ligament is susceptible to tearing when subjected to forces surpassing its tolerance level. This often occurs due to a sudden force or trauma applied to the knee joint.
Some common causes of PCL tears include sports injuries, motor vehicle accidents, falls, and hyperextension. Individuals with a history of prior knee injuries may also have a heightened risk.
Symptoms Of PCL Tear
The symptoms of a PCL tear can vary depending on the severity of the injury, but common signs include:
- Pain: Pain behind the knee, particularly at the back of the knee joint, is a common symptom of a PCL tear. The pain may range from mild to severe and can be aggravated by activities that stress the knee.
- Swelling: Swelling around the knee joint is another typical symptom of a PCL tear. The swelling may develop rapidly following the injury or gradually over time and is often accompanied by stiffness in the knee.
- Instability: Patients with a PCL tear may experience feelings of instability or “giving way” in the knee, especially when attempting to bear weight or engage in activities that require bending or twisting of the knee joint.
- Difficulty bearing weight: A PCL tear can make it challenging to put weight on the affected leg, particularly when walking, standing, or climbing stairs.
- Decreased range of motion: Some individuals with a PCL tear may experience a limited range of motion in the knee and find it difficult to fully straighten or bend the leg.
How Is PCL Tear Diagnosed?
A physical examination will be conducted to determine the circumstances of the injury and evaluate symptoms. The healthcare professional will also perform specific manoeuvres to assess knee stability and range of motion.
Imaging tests, such as an X-ray, MRI, or ultrasound scan, may be ordered to confirm the diagnosis and assess the extent of the injury. X-rays can help rule out fractures or other bony abnormalities, while MRI scans provide detailed images of soft tissue structures like ligaments to help identify PCL tears.
Specialised tests may also be conducted to assess the degree of PCL instability and determine the severity of the injury. These tests involve applying controlled forces to the knee joint to evaluate the movement of the tibia relative to the femur.
How Is PCL Tear Treated?
The treatment approach for a PCL tear depends on the severity of the injury, the individual’s activity level, and their overall health and goals. In cases of mild to moderate PCL tears, conservative treatments such as rest, physical therapy, and bracing may be sufficient to manage symptoms and promote healing.
For more severe or complete tears of the PCL, surgical intervention may be necessary to repair or reconstruct the damaged ligament. This may include PCL repair, where the torn ligament is reattached to the bone using sutures or anchors, or PCL reconstruction, where a graft from another part of the body or a donor tendon is used to replace the damaged ligament.
The healthcare professional will conduct a thorough evaluation to determine the most appropriate treatment plan based on each individual’s needs and circumstances.
Anatomy/ Pathology
The PCL (anterior cruciate ligament) is a short, thick ligament that resists backward translation of the tibia. It is often ruptured either by hard impacts to the flexed knee (eg knee smashing into the dashboard of a car during an accident) or hyper-extension of the knee.
Frequently Asked Questions
Can a PCL Tear Heal?
What activities should I avoid after my injury?
Is physical therapy necessary after PCL surgery?
What can I do to prevent a PCL tear?
Can I return to sports?
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