Knees give the lower body its mobility. Walking, bending the legs, or keeping the body upright is only possible with them. There are times when excess weight leaves the knees vulnerable to injury or damage. The PCL ligament tear is one such injury and among the most debilitating to afflict the knees.
You can overcome this injury with prompt orthopedic care.
The knee is a significant joint connecting bones in the upper and lower leg. Surrounding the joint and bone are soft tissues such as ligaments. The posterior cruciate ligament, or PCL, connects the shin and thigh bones to neighboring structures. This ligament is essential for allowing the knee to operate appropriately.
The PCL has a greater width and tensile strength than the neighboring anterior cruciate ligament or ACL. As a result, the PCL is less prone to injury than the ACL. Still, PCL tears make up 20% of all knee-related injuries, often occurring with other damages. PCL tears typically occur when the ligament is stretched beyond its capacity.
The severity of ligament tears is categorized via grades.
Grade 1: Denotes a partial tear.
Grade 2: Describes partial tears that contribute to minor joint instability.
Grade 3: Denotes a complete tear of the PCL that renders it noticeably unstable.
Grade 4: Denotes the most severe injury to the PCL and surrounding ligaments.
PCL injuries are typically caused by some significant knee trauma. Common causes include:
- Accidents or falls from notable heights.
- Landing hard on an already bent knee.
- Unusually awkward bending or twisting.
Many PCL injuries happen due to the forceful and direct impacts common in full-contact sports.
The risk of a PCL tear increases with whole-contact sports like football and mixed martial arts. Sports such as tennis, skiing, and basketball pose their challenges as they often demand the legs stretch or bend into unusual positions.
Physically demanding work and irritating a preexisting ailment can increase the risk of a PCL tear. The risk of a PCL tear also increases with age as ligaments weaken and lose flexibility as the body gets older.
The level of discomfort can range in intensity depending on how severe the injury is. Pain may worsen if you attempt to walk or stand on the damaged knee for prolonged periods. Swelling often follows. The affected region may grow stiff, severely reducing joint stability.
PCL injuries can result in further complications if not correctly identified and treated. Mild to moderate tears may worsen with time and sustained movement. Untreated soft tissue injuries weaken the connection of neighboring muscles and bones.
Diagnosis is typically a multi-step process. During the preliminary exam, your doctor will check the leg for any obvious signs of swelling or bruising. PCL injuries often limit flexibility and mobility in the leg. The doctor will assess to determine the leg’s range of movement.
Then, your doctor will order internal imaging tests. X-rays, magnetic resonance imaging, MRI scans, computerized tomography, or CT scans capture images of the knee’s bones, muscles, and soft tissue. Using these images, the doctor can determine the severity of the PCL tear.
Treatment options depend on the severity of the tear. Home care methods are often adequate for addressing mild injuries. Moderate to severe damage may need surgery.
Your doctor may first treat a mild case using a first aid strategy abbreviated RICE. This acronym is short for:
- Rest – Remain off the injured extremity as much as possible. Rest will prevent the wounded leg from incurring any undue stress.
- Ice – Ice reduces swelling, and cold alleviates pain and discomfort. Place ice or an ice pack into a towel or compress and place it atop your knee for 15-minute intervals at least four times a day.
- Compression – Wrap the injured knee in a large elastic bandage. Compression will keep the damaged ligament in place and mitigate the risk of exasperation.
- Elevation – Elevate the leg to promote blood flow and speed up healing.
Mild to moderate injuries may be treated with over-the-counter or prescription pain-relieving medications and walking aids such as crutches or orthopedic scooters. Moderate injuries may, at times, need physical therapy. These individual treatment methods are designed to meet your specific needs as you regain the strength or mobility you lost.
In most cases, attempts to reattach the torn band of soft tissue do not work. Surgeons must reconstruct the damaged ligament via tissue grafts. In this procedure, the surgeon takes tissue from another part of your body or a donor. The surgeon uses the new tissue to rebuild the damaged tissue.
Surgeons often perform PCL ligament replacement surgeries using a tool called an arthroscope. The tube-shaped instrument is inserted into small incisions near the joint. The arthroscope has a light, tools, and a camera that sends images to a large monitor, allowing surgeons to perform various procedures more precisely.
Recovery time will depend on several factors, including:
- Age of patient.
- Patient’s level of physical activity.
- Overall health of the patient.
- Injury’s severity grade.
- Treatment method.
- Response to treatment.
Mild cases tend to heal after a month or two of home care treatment. Surgery may lengthen the healing process to six months or even a year. Everyone heals at their own pace, so establishing specific recovery times is difficult.
You can reduce the risk of a PCL injury through safeguarding measures such as:
- Keeping Soft Tissues Loose – Before participating in any strenuous exercise or physical labor, you should stretch and bend your knees.
- This strengthens soft tissues and neighboring features.
- Wearing Protection – Wear protective coverings like pads or braces that may shield knee ligaments from the damage incurred via forceful contact.
- Using Proper Exercise Techniques – Always maintain proper posture and use the safest techniques when engaging in physical activity.
If you have sustained a PCL injury or are experiencing symptoms, please consult Dr. Peter Howard. Dr. Howard is a highly acclaimed orthopedic surgeon and sports medicine specialist who has diagnosed and treated countless PCL injuries.