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Posterior Cruciate Ligament Injury by Diana Kohnle

Definition

The posterior cruciate ligament, or PCL, is a piece of connective tissue located within the knee near the back. The PCL connects the thighbone to the shinbone, and keeps the shinbone from moving too far backward.

When a strong force (such as during a sports activity or other high-stress activity) is applied to the PCL, the ligament can become strained or torn.

While an injury to the PCL requires extensive treatment and rehabilitation, the injury is treatable and rarely causes long-term serious complications. Complete recovery usually takes six months.

Posterior Cruciate Ligament

Causes

Injury to the PCL can be caused by a variety of events, including:

Sports injury
Motor vehicle accident
Fall on a bent knee
Strong force to the leg immediately below the kneecap
Knee dislocation

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of injuring the PCL:

Playing sports, especially football
Injury to the knee, including dislocation

Symptoms

Symptoms include:

Swelling in the knee, usually within three hours of an injury
Soreness in the area behind the knee
Weakness or instability in the knee (feeling like the knee is "giving way")
Pain in the knee
Difficulty walking on the knee
Pain when moving the knee

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:

MRI scan of the knee joint—a test that uses magnetic waves to make pictures of structures inside the knee joint
X-ray of the knee joint—a test that uses radiation to take a picture of structures inside the body. In this case, x-rays are used to show damage to any bones around the PCL.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment will depend on the type and severity of PCL injury, but typical treatment options include:

RICE (Rest, Ice, Compression, Elevation)

This treatment is recommended for only minor tears. Crutches may also be needed to alleviate straining the area while it is healing. Over-the-counter pain relievers may also be taken to reduce pain and swelling.

Surgery

Surgery may be required to stabilize a torn PCL. Surgery may require reconstruction of the ligament, or reattachment of the ligament with tiny screws. This is usually done only in high performance athletes.

Rehabilitation

Patients usually attend rehabilitation therapy following a PCL injury. Rehabilitation will strengthen muscles around the knee and restore function to the area. Therapy typically includes many exercises for the muscles of the thigh.

Prevention

Most PCL injuries occur during accidents that are difficult to prevent. To reduce your chance of injuring the PCL, take the following steps:

Always properly stretch your legs before exercise.
Protect your knees by doing regular strengthening exercises for your thighs.
Maintain proper technique when exercising or playing sports.

RESOURCES:

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
Orthogate http://www.orthogate.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Health Canada http://www.hc-sc.gc.ca/index-eng.php/

References:

Cross MJ. Anterior cruciate ligament injuries: treatment and rehabilitation. In: Fahey TD. Encyclopedia of Sports Medicine and Science . Encyclopedia of Sports Medicine and Science website. Available at: http://sportsci.org/encyc/aclinj/aclinj.html . Accessed June 24, 2007.
Posterior cruciate ligament injury. The Mayo Clinic website. Available at: http://www.mayoclinic.com/health/posterior-cruciate-ligament/DS00928/DSECTION=8 . Accessed June 24, 2007.
Posterior cruciate ligament injury. The University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/sma/sma_pocrulig_sma.htm . Accessed June 24, 2007.
Posterior cruciate ligament (PCL) tear. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=236 . Accessed June 24, 2007.

Last reviewed September 2011 by Rosalyn Carson-DeWitt, MD

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