PCL Injury
Description
Reviewed by Dr. Peter Simonian
A ligament is a tissue anywhere in the body that connects one bone to another. Within the knee, four ligaments stabilize the joint: the Anterior Cruciate Ligament, the Medial and Lateral Collateral Ligaments, and the Posterior Cruciate Ligament, or PCL. This report details what occurs when your PCL tears, either completely or partially. An injury to the PCL or any other ligament is known as a "sprain," or, more commonly, a "tear" when it is most severe, and is the rarest of the four types of major ligament tears within the knee. The PCL runs from the front of the femur, or thighbone, to the back of the tibia, or shinbone, and prevents the tibia from moving too far backward relative to the femur. The PCL is injured or torn when the tibia is forced backward relative to the femur, stretching or tearing the ligament. The injury can happen in one of three "grades": - Grade 1, in which the ligament is stretched, but not torn.
- Grade 2, where the PCL is partially torn.
- Grade 3, in which the PCL is completely torn and instability, or looseness of the joint, occurs.
Depending upon the level of activity of the individual, an orthopedic surgeon may decide to operate or pursue conservative methods to manage the PCL tear. A PCL tear often accompanies dislocation or an ACL tear.
Symptoms
Of the four major ligaments within the knee, (the Medial Collateral and Lateral Collateral, and the Anterior and Posterior Cruciate Ligaments), the PCL is perhaps the least noticeable when it is torn. A PCL tear is marked by a degree of instability, but less pain and swelling than marks a tear of the ACL or collateral ligaments. Often, a tear of the PCL is less noticeable because the other ligaments tend to "pick up the slack" for the torn or avulsed ligament.
Cause and Risk Factors
Causes
- Direct blow to the front of the knee while it is bent
- Dislocation of the kneecap
- Injury to other knee structures decreasing stability within the joint
Risk Factors
Contact sports and other activities that pose a risk for a strong blow to the knee or a wrenching, twisting motion that may cause it to dislocate pose a high risk for PCL injury.
Treatment
Immediate Action
- If a PCL tear is suspected, remember RICE: Rest, Ice, Compression, and Elevation. The RICE method is the best thing for most injuries for the first two to three days. If swelling persists or the knee is weak or wobbly, consult a doctor. If a doctor decides surgery is necessary, he or she will not perform it until the swelling from the injury goes down.
- An ace bandage may provide comfort and prevent swelling.
- Use crutches, if necessary.
See your doctor if:
The pain is too much to bear.
You sprain your knee more than once
You have knee pain, swelling or stiffness that lasts more than a few days.
Your knee feels week or wobbly.
Procedures
If a doctor suspects a PCL tear, he or she will likely order an MRI and X-Rays. The doctor will also give a thorough knee examination to determine the laxity (looseness), strength, and pain points within the joint. Not all PCL injuries require surgery. See your physician to discuss options appropriate for your age and level of activity. Depending on desired level of activity and degree of involvement in sports, non-operative management may be adequate. However, a doctor has many methods at his or her disposal, should PCL repair or reconstruction surgery be necessary.
Prevention
PCL injuries are often accidental, but certain steps can minimize your risk for incurring one. Strengthening your hamstring, calf and quadriceps muscles may create a stronger, tighter knee joint that is more resistant to injury. Avoidance of contact sports also greatly reduces your risk for a PCL tear.
Last updated: 26-Oct-01
|
| |
|
|
|
