Torn Posterior Cruciate Ligament (PCL)

The posterior cruciate ligament is located in the back of the knee. It is one of several ligaments that connect the femur (thighbone) to the tibia (shinbone). The posterior cruciate ligament keeps the tibia from moving backward too far. It is stronger than the anterior cruciate ligament and is injured less often. The posterior cruciate ligament has two parts that blend into one structure which is about the size of a person’s little finger.

An injury to the posterior cruciate ligament requires a powerful force. A common cause of injury is a bent knee hitting a dashboard in a car accident or a football player falling on a knee that is bent.

Causes
There are many possible causes of a torn posterior cruciate ligament (PCL). It typically requires a powerful force.

A direct blow to the front of the knee (such as a bent knee hitting a dashboard in a car crash, or a fall onto a bent knee in sports)

Pulling or stretching the ligament (such as in a twisting or hyperextension injury)

Simple misstep

Symptoms of a Torn Posterior Cruciate Ligament (PCL)
The typical symptoms of a torn posterior cruciate ligament (PCL) are:

Pain with swelling that occurs steadily and quickly after the injury

Swelling that makes the knee stiff and may cause a limp

Difficulty walking

The knee feels unstable, like it may “give out”

Treatment
Nonsurgical Treatment

If you have injured just your posterior cruciate ligament, your injury may heal quite well without surgery Your doctor may recommend simple, nonsurgical options:

RICE. When you are first injured, the RICE method — rest, ice, gentle compression, and elevation — can help speed your recovery.

Immobilization. Your doctor may recommend a brace to prevent your 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) has been shown to be a key factor in a successful recovery.

Surgical Treatment

Your doctor may recommend surgery if you have combined injuries. For example, if you have dislocated your knee and torn multiple ligaments including the posterior cruciate ligament, surgery is almost always necessary.
Rebuilding the ligament: Because sewing the ligament ends back together does not usually heal, a torn posterior cruciate ligament must be rebuilt. Your doctor will replace your 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 posterior cruciate ligament 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.
Surgical procedures to repair posterior cruciate ligaments continue to improve. More advanced techniques help patients resume a wider range of activities after rehabilitation.