PCL Injury; Causes, Symptoms, Diagnosis, Treatment

Posterior cruciate ligament (PCL) is a tough tissue structure with a high tensile strength that essentially controls the positioning of the tibia and the femur. Besides connecting the bones, it stabilizes the knee joint while it rotates in different directions. Any tear or stress in this ligament is termed as PCL injury.

It is not a common condition and generally occurs in combination with other ligament injuries and cartilage damages. PCL injury can vary in degree from a mild stretch to complete tear of the ligament, with a piece of the bone being dethatched along with the tissue structure. Sportsperson who indulge in football, soccer, skiing etc. are at a higher risk of ligament injuries.

Causes

  • Falling on a flexed knee
  • Direct injury or trauma to the shin bone (tibia)
  • Vehicular accidents in which the legs are crushed against the dashboard

Symptoms

  • Mild or sharp knee pain, depending on the grade of injury
  • Swelling and tenderness in the joint
  • Unstable knee joint
  • Inability to walk, stand or bear body weight

Diagnosis

  • The knee specialist may inquire about mode of injury, symptoms as well as the medical history
  • A device called arthrometer may be used to check ligament strength or tightness
  • The patient may be asked to lie on his back while bending the knees. The upper portion of the shin bone is examined through palpation which helps to confirm PCL injury
  • Analysis of the gait
  • X-ray imaging to check for bone damage, if any
  • MRI or CT scan to locate the exact point of tear/stress to the ligament
  • Bone scan may be required in case of chronic PCL injuries. Both the legs are compared to reach a diagnosis
  • The doctor may check for fluid retention or internal bleeding within the joint that may cause pressure to build up
  • Arthroscopy may be used to get a better view of the joint

Treatment

  • Rest the injured knee and avoid any weight bearing or activity that may cause stress
  • Use of ice packs may reduce pain and swelling
  • Slight compression may be applied
  • Keep the leg elevated at chest level while resting
  • Anti-inflammatory medicines may be prescribed for immediate relief
  • Physical therapy may be helpful in stabilizing the joint, aiding in recovery and strengthening
  • A crutch or a knee brace may be used for supporting the affected joint
  • Surgery may be recommended in high grade injuries which do not respond to conservative methods. If a piece of bone is detached along with the ligament, it may be surgically fastened using pins and screws
  • Torn PCL ligament is surgically replaced by a part of tissue extracted from a donor or by using tissues from the patient’s body (thigh or heel)
  • Minor tissue injuries can be corrected using an arthroscope which enables correction through minor incisions

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