Posterior cruciate ligament injury is a relatively rare knee injury occurring during severe trauma. It usually develops during a knee sprain and is commonly accompanied by injuries to other structures inside the joint.

Posterior cruciate ligament injury results from high-energy trauma.

It is accompanied by injury to other knee structures, such as the menisci or anterior cruciate ligament.

In physically active people, this injury requires multiligament reconstruction.

Symptoms

Early – after the injury

  • a feeling of instability in the affected knee
  • knee locking
  • a catching sensation in the knee
  • inability to bear full weight on the limb after injury
  • an audible crack in the knee
  • swelling
  • pain

Late symptoms of chronic PCL injury

  • a feeling of instability, the knee giving way or buckling when walking, particularly when running on uneven ground or suddenly changing direction
  • a feeling that the lower leg drops relative to the thigh when the knee is bent

Diagnostics

  • diagnosis is based on a proper orthopaedic examination, including instability tests that allow a reliable diagnosis with a high degree of probability
  • ultrasound and conventional X-rays are useful additional examinations that often confirm the initial diagnosis
  • MRI is particularly suitable for confirming a posterior cruciate ligament injury

Treatment

  • most patients with posterior cruciate ligament injuries need non-surgical treatment, beginning with immobilisation in a brace followed by an intensive rehabilitation programme
  • patients with marked knee instability or multiligament injuries, involving several ligaments in the same knee, require surgery. The damaged ligament is replaced with a graft formed from the gracilis and/or semitendinosus tendons and fixed in the femur and tibia using an appropriate implant system. The operation is performed arthroscopically.

Postoperative management

  • in most cases, patients can leave hospital on the second or third day after arthroscopic treatment of posterior cruciate ligament injuries
  • patients usually use forearm crutches for six weeks to protect the operated knee
  • the operated limb is supported by a knee brace for approximately six weeks
  • Thrombosis prevention is necessary during the period of immobilization in the orthosis.
  • Patients discharged home learn the basic ways to manage postoperative swelling.
  • patients begin an intensive rehabilitation programme on the first day after surgery, individually developed for each patient by our rehabilitation team