INTRODUCTION​

• The Posterior cruciate ligament (PCL) is one of the major knee ligaments providing stability to the knee

• The primary function of the PCL is to prevent the leg bone from moving back relative to the thigh bone. 

• Injury to the PCL leads to knee instability and buckling, which is associated with pain, swelling and apprehension

• Patients with chronic PCL tears often develop arthritis in the knee

• 10% of knee ligament injuries are PCL tears

CAUSES

• PCL tears usually occur in the setting of multiple knee ligament injury 

• They can also occur in isolation with a direct force directed back on the shin bone with the knee in a flexed position

• Common mechanisms of injury include car dashboard injuries and falling directly on the shin bone

SIGNS AND SYMPTOMS

• PCL tears are almost always associated with immediate pain in the back of the knee and mild swelling

• Instability of the knee, such as giving out and buckling, is common after PCL tears

TREATMENT​​

• Treatment of partial thickness PCL tears that are stable on physical exam are usually managed without surgery. Treatment consists of a physical therapy rehab program with a focus on strengthening the quadriceps and knee extensors. The reason for this is to counteract the direction of instability by strengthening the muscles that bring the shin bone forward relative the thigh bone

• Full or complete PCL tears, especially when combined with other knee ligament tears, are usually managed with surgery 

• Surgery is arthroscopic-assisted and consists of using a graft to reconstruct the PCL

• There are numerous graft options, but in general younger patients use their own tissue (autograft) for the graft, while older patients may benefit from a donor graft (allograft)

• Graft options include hamstring, and quadriceps options. Outcomes are similar with all of these graft options

        PREVENTION

• The best way to prevent an PCL tear is to work on strengthening your quadriceps and preventing activities and positions that can increase the likelihood pf PCL injury