P OSTERIOR C RUCIATE L IGAMENT By; Maria Guzman

T HE P OSTERIOR C RUCIATE L IGAMENTS (PCL) Is one of a pair of ligaments that are found in the middle of the knee. Originates on the posterior (back) tibia (shin bone) and attaches on the anterior (front) femur ( thigh bone). PCL prevents the tibia from displacing backward on the femur. It also provides rotational stability.

W HAT I S I T ? A PCL injury is a sprain (stretch or tear of a ligament). The PCL most often is sprained when the front of the knee hits the dashboard during an automobile accident. During sports activities, the PCL also can tear when an athlete falls forward and lands hard on a bent knee, which is common in football, basketball, soccer and especially rugby.

A NATOMY

T HE POSTERIOR CRUCIATE LIGAMENT (PCL) IS A POWERFUL LIGAMENT EXTENDING FROM THE TOP - REAR SURFACE OF THE TIBIA TO THE BOTTOM - FRONT SURFACE OF THE FEMUR. T HE LIGAMENT PREVENTS THE KNEE JOINT FROM POSTERIOR INSTABILITY.

S YMPTOMS Mild knee swelling, with or without the knee giving out when you walk or stand, and with or without limitation of motion Mild pain at the back of the knee that feels worse when you kneel Pain in the front of the knee when you run or try to slow down – This symptom may begin one to two weeks after the injury or even later.

L IKE OTHER TYPES OF SPRAINS, PCL INJURIES ARE CLASSIFIED ACCORDING TO A TRADITIONAL GRADING SYSTEM. Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable. Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament. Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.

T REATMENT Nonsurgical Treatment RICE. When you are first injured, the RICE method - rest, ice, gentle compression and elevation — can help speed your recovery. Immobilization. The Doctor may recommend a brace to prevent knee from moving. To further protect your knee, you may be given crutches to keep you from putting weight on your leg. Physical therapy. As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it. Strengthening the muscles in the front of your thigh (quadriceps)

S URGICAL T REATMENT Your doctor may recommend surgery. For example, dislocated knee and torn multiple ligaments including the posterior cruciate ligament. Rebuilding the ligament. sewing the ligament ends back together does not usually heal, a torn PCL must be rebuilt. doctor will replace the torn ligament with a tissue graft. This graft is taken from another part of your body, or from another human donor (cadaver). It can take several months for the graft to heal into your bone. Procedure. Surgery to rebuild a PCL is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.

R EHABILITATION Proper Rehabilitation begins with control of pain, swelling, regaining normal range of motion. As swelling and pain decrease strength training should be instituted. Strength training should focus on the quadriceps muscle group. The quads will provide an anterior pull on the tibia, removing stress from the PCL.quadriceps

S UMMARY PCL knee injury is a serious knee injury, although not terribly common. It results from forced knee flexion, or a direct blow to the front of the low leg. PCL tears produce swelling, pain, loss of motion, and instability, and can be treated conservatively, but may require surgical intervention.

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