Monday, March 6, 2017

What’s a PCL Injury and How Is It Treated?



Because ACL tears are more common, PCL tears don't get as much attention - but that doesn't mean they aren't serious. In fact, PCL tears can be just as (if not more) debilitating as ACL tears. Here's everything you need to know:

Related Knee Anatomy and Terms

The knee is made up of four ligaments that stabilize and protect the knee. The collateral ligaments (MCL and LCL) are found on the outside of the knee. And the cruciate ligaments (ACL and PCL) are found on the inside.



Illustration 1- PCL related anatomy

Cruciate Ligaments

·      Anterior cruciate ligament (ACL)
·      Posterior cruciate ligament (PCL)

The PCL is the strongest knee ligament and it’s job is to prevent the shinbone from displacing posteriorly (moving too far back).

PCL Injuries: Causes and Diagnoses

PCL injuries most commonly occur due to:

·      Car accidents
·      Sports collisions
·      A direct blow to the knee

Injuries to the PCL can be mild or severe and are classified into three grades:

·      Grade 1 refer to a slightly stretched ligament
·      Grade 2 refer to a partially torn ligament
·      Grade 3 refer to a completely torn ligament

Grades 1 and 2 sprains are treated non-operatively so long as there as no other damage to the surrounding ligaments or tendons in the knee.

Non-Operative Treatment

Commonly prescribed non-surgical treatment options are:

1.    Immobilization. A knee brace keeps the knee stable while the sprained ligament heals. After a few weeks, the knee is healthy and the patient can return to normal activities.

2.    Physical Therapy. Exercises help strengthen and stretch the ligaments and muscles of the knee so that it functions properly and is protected.

3.    NSAIDs. Anti-inflammatory medications help reduce pain and expedite the healing process.

In most cases, patients who respond well to non-operative treatment recover quickly.

Operative Treatment

When the injury is classified as Grade 3, the torn PCL can be repaired using arthroscopic surgery. During the procedure, the orthopedic surgeon detaches the damaged ligament and replaces it with a ligament graft, that’s taken from the patient's hamstrings or from those of a cadaver.  The goal of this procedure is to stabilize the knee joint and return the PCL to its normal anatomical position in the knee.



Illustration 2- Arthroscopic surgery is used to repair a torn PCL

Recovery

Patients are usually allowed to go home the same day as this surgery. After a week or two of rest, physical therapy can begin. Under the guidance of a physical therapist and the operating surgeon, patients can expect to fully recover anywhere between 8-12 months.

Contacting an Orthopedic Specialist


You now know some of the signs associated with a PCL tear. If any of them sound familiar, you should be seen by an orthopedic surgeon. At Advanced Bone & Joint in St. Peters and O'Fallon, our team of Orthopedic and Sports Medicine Specialists can create a unique plan for you based on your specific injury, lifestyle and goals. Give us a call and we’ll get you an appointment ASAP.

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