They most often occur when an athlete twists or pivots during play. ACL reconstructive surgery is done to repair a torn ACL and regain stability and movement in the knee.
References Overview Posterior cruciate ligament PCL injury is typically caused by direct trauma to a bent knee. Limited information exists regarding the optimal management of a PCL injury but conservative management physiotherapy and bracing is often effective for isolated partial tears or complete ruptures.
Surgery may be required for individuals with persistent symptoms despite appropriate conservative treatment, avulsion fractures of the PCL or multi-ligament knee injuries. Anatomy The posterior cruciate ligament PCL is located within the knee joint and consists of two separate bundles anterolateral and posteromedial that connect the shin tibia to the thigh bone femur figure The tension in each bundle changes depending on knee position and whether movement is being performed passively e.
Overall, greater force is placed on the PCL when the knee is bent flexed or over-straightened hyperextended figure 3.
From Anderson et al PCL force at different knee flexion angles. From Markolf et al The PCL is thought to provide structural stability to the knee via its direct connection between the bones, and functional stability by providing information to the nervous system regarding knee joint position proprioception.
Causes The PCL is the main constraint to backwards posterior translation of the upper proximal tibia on the femur; the mechanism of injury for an isolated PCL injury is typically a posteriorly directed force to the proximal tibia with the knee bent e. PCL injury may also occur when the knee is excessively flexed hyperflexion while a downward force is exerted on the thigh.
The PCL plays a secondary role in resisting side to side and rotational movements, or over-straightening hyperextension of the knee.
Therefore, any forceful sideways, rotational or hyperextension movements can injure the PCL but this is unlikely to occur without additional injury to another major knee ligament. In severe injuries, the knee may appear deformed due to dislocation of the tibia; if major blood vessels are injured during the dislocation vascular injury there may be associated neurovascular signs and symptoms.
Individuals may describe a noise pop, snap or cracktearing sensation, significant pain or immediate swelling within the joint haemarthrosiswith possible bruising at the back of the knee; X-rays are indicated for individuals with a positive Ottawa Knee Rule or a tense haemarthrosis, to confirm or exclude knee fracture.
In contrast, some individuals may be unaware that they have torn their PCL as they do not experience significant symptoms at the time of injury. If present, individuals may describe vague symptoms such as discomfort at the back of the knee or pain with kneeling. Since more force is placed on the PCL as the knee bends, knee instability may not be an issue whilst the knee is relatively straight e.
If instability is experienced when the knee is straight, there is likely to be additional medial innerlateral outer or anterior cruciate ligament involvement. As a priority, it is therefore important to assess for vascular injury in known or suspected cases of knee dislocation.
Clinical tests that quantify posterior translation of the tibia are used to assess the integrity of the PCL, as described below.To understand how posterior cruciate ligament injury can occur, one must consider the anatomical and physiological properties of the PCL.
The PCL is located within the knee joint where it stabilizes the articulating bones, particularly the .
The Rebound PCL is designed to apply a physiologically correct dynamic force, optimum for rehabilitation of posterior cruciate ligament (PCL) ruptures, whether during functional (non-surgical) treatment or post-surgical reconstruction. Posterior Cruciate Ligament (PCL) Injury - description of symptoms, causes and treatment, including images.
Mar 20, · The posterior cruciate ligament (PCL) is described as the primary stabilizer of the knee by many authors.
PCL injuries are less common than anterior cruciate ligament (ACL) injuries, and they often go unrecognized. The posterior cruciate ligament (PCL) is a ligament within the knee.
Ligaments are tough bands of tissue that connect bones. The PCL -- similar to the anterior cruciate ligament (ACL) -- connects.
[nee] – timberdesignmag.com joint of the leg that allows for movement between the femur (thighbone) and tibia (shinbone) and has a sesamoid bone called the patella (kneecap) that offers protection and increases the power of the muscles surrounding the knee.