> PCL Tear
What is the Posterior Cruciate Ligament?
The PCL (posterior cruciate ligament)
is about two inches long and connects the thighbone
(femur) to the shinbone (tibia) deep in the rear of
the knee. It limits the backward motion of the knee,
preventing the knee from hyperextending (bending the
"wrong" way). When the knee is twisted or
hyperextended, or there is a violent blow to the front
of the knee while it is bent, the PCL can be torn, leaving
the knee unstable and possibly unable to support a person's
The PCL (posterior cruciate ligament) is about two inches
long and connects the thighbone (femur) to the shinbone
(tibia) deep in the rear of the knee. It limits the
backward motion of the knee, preventing the knee from
hyperextending (bending the "wrong" way).
When the knee is twisted or hyperextended, or there
is a violent blow to the front of the knee while it
is bent, the PCL can be torn, leaving the knee unstable
and possibly unable to support a person's full weight.
PCL tears are infrequently caused
by sports injuries. Because the PCL is the strongest
of the knee ligaments, and because it is located deep
inside the knee, tears are most often associated with
traumatic injuries such as those resulting from car
accidents. A tear can happen when the knee is violently
forced backward with the leg straight, or when it is
hit directly in front of the knee while the knee is
bent, such as might happen to someone's knee striking
a dashboard during a car accident. Because a violent
blow to the knee is usually needed to tear the PCL,
the injury is usually accompanied by injuries to other
knee ligaments. A tear of the PCL without other ligament
damage is extremely rare. Though rare in sports, PCL
tears can occur when playing soccer, football, or other
sports in which it is possible for the knee to receive
a severe frontal blow.
Isolated PCL tears are frequently
treated with rehabilitation rather than with surgery.
However, surgery is typically considered when PCL tears
are accompanied by other ligament injuries. Deciding
whether to have or to forego surgery to repair a torn
PCL may be partly a personal choice, but age, physical
condition, and athletic goals may also play a role in
the decision. Those who are not very active may choose
an exercise strengthening program instead of surgery,
since the injury is not likely to interfere with their
daily activities. Such a program can take as long as
six months to complete.
| Orthopedic Evaluation
are usually three parts to an orthopedic evaluation:
medical history, physical examination, and tests your
physician may order.
Your doctor will likely ask you how you injured your knee,
how it has been feeling since the injury, and if your
knee has been previously injured. Physicians also typically
ask about other conditions, such as diabetes and allergies,
and medications currently being taken. The doctor may
also ask about your physical and athletic goals
information that will help him decide what treatment might
be best for you in achieving those goals.
Because the PCL is deep inside the knee, it is difficult
to feel around in search of pain or tenderness. Here
are two things that will probably be done in examining
your possible torn PCL:
the knee bent 90 degrees, the doctor will push the shinbone
(tibia) back in what is called a posterior drawer test.
If the tibia moves excessively backward, that would
strongly suggest a torn PCL.
and tendons do not show up on X-rays, but X-rays of
your knee may be taken to rule out any fracture or dislocation.
Should your physician require a closer look, these
tests may be conducted:
(magnetic resonance imaging) has an accuracy rate of
nearly 90 percent in determining whether a PCL has been
torn and to what extent it has been damaged. While it
shows the soft tissues, it is not very good at showing
the details of a partial tear. MRI is painless and does
not require any needles or dyes.
surgery, in which the doctor inserts a tiny camera
into your knee, is the best way to examine a partial
tear. Arthroscopy allows the physician to examine the
PCL to determine the extent of the tear. This is done
on an outpatient basis.