PCL Tear

Introduction/ What is?

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 are the symptoms?

The common symptoms of PCL tears are:

  1. Popping sound/ feeling during the injury
  2. Significant pain at the back of the knee immediately after the injury
  3. Patients are still able to stand and limp even if they have suffered a complete PCL rupture
  4. There may or may not be much swelling of the knee

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. 

What caused it?

As the PCL’s primary function is to prevent the tibia from translating backwards, it can be torn when forces pushing the tibia backwards or extending the knee beyond its natural range exceeds the PCL’s strength.  

Can it heal?

Yes the PCL can heal but it often heals slightly more elongated than it’s natural length.

What tests can be done to diagnose this?

An MRI scan is by far the best way to detect presence of a PCL tear.

What treatment options are there?

Even though the PCL heals in an elongated state, it is often very well tolerated. Many patients with PCL tears continue to be active in sports. Surgical reconstruction is often not required.
Some patients with isolated PCL or PCL tears accompanied by tears of other knee ligaments, experience instability of the knee. In these cases, an PCL reconstruction may be required to restore stability to the knee.

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