Sports Medicine and Exercise Information  

Dr. Allan Mishra | Knee Pain Diagnosis


(PCL injury)

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Definition Partial or complete rupture of the posterior cruciate ligament

The posterior cruciate ligament is located in the back of the knee and is responsible for limiting backward movement of the shin bone (Tibia) with respect to the thigh bone (Femur). It is a relatively rare injury that occurs most often in football players, hockey players and skiers. It may also result from a car accident.

A tear of the PCL occurs via two classic mechanisms. The first is falling on a bent knee. This pushes the shin bone back and tears the PCL. This same mechanism ruptures the PCL when the knee hits the dashboard in a car accident. The second mechanism is when the knee is hyperextended (bent backwards). Finally, the PCL may be torn in conjunction with the anterior cruciate ligament (ACL) via a violent twisting of the knee.

PCL injuries are diagnosed by first attempting to obtain a history of one of the above mechanisms. The injury may be associated with a "pop" in the knee and immediate swelling. The physical exam will show moderate knee swelling and pain with motion. A variety of maneuvers by your doctor will then be done to elicit the backward instability of the knee caused by the tear of the PCL. X-rays are done to rule out fractures. An MRI scan may also be order to confirm the diagnosis and evaluate the cartilage within the knee.

MRI of Normal and Torn PCL

Nonoperative: Most PCL injuries can be treated with an aggressive physical therapy dedicated to strengthening the quadriceps and hamstring muscles. Coordination retraining and bracing also play a role.

Surgery is usually reserved for severe injuries that are not responsive to nonoperative treatment. PCL tears that occur in combination with other ligament injuries may also require reconstructive surgery. Finally, elite athletes who demand perfect knee stability may elect to have surgery.

Maintain excellent strength and stability of the knee