Posterior Cruciate Ligament (PCL) Tear

Development of PCL Tear Injuries to the PCL are the most uncommon and also most difficult to diagnose Motor vehicle accidents (“Dash board injury”) Contact sport or fall injuries where an individual falls on a bent knee with foot in plantar flexion

Symptoms of PCL Tear There are three grades with different symptoms and severity Grade 1 symptoms (stretched ligament) Mild Tenderness on the inside of the knee No swelling need be present Pain on Posterior Drawer stress test but no laxity Grade 2 symptoms (partial thickness tear of the ligament) Significant pain in the medial aspect of the knee Moderate swelling present Posterior Drawer stress test will indicate moderate instability Grade 3 symptoms (full thickness tear, or complete tear) Varied amounts of pain Significant joint laxity on Posterior Drawer stress test Complaints of instability (“wobbly” or “unstable” complaints) These injuries can also include tears to the ACL

Symptoms of PCL Tear Knee swelling in a PCL tear appears rapidly Within 3 hours Difficulty walking or a slight limp Pain with running, decelerating, or navigating stairs in any direction

Grades of Ligament Tears

Differential Diagnosis Tests Godfrey sign Posterior Drawer test Ultrasound imaging MRI imaging

Godfrey’s sign

Posterior Drawer Test

Recommendation Time from injury, location, severity, and concomitant injuries will indicate need for surgery or if conservative treatment will be sufficient Surgery indicated immediately in presence of multiple ligamentous injuries R.I.C.E. Immobilization and use of functional brace As swelling subsides Rehabilitation can begin stretching and strengthening exercises as well as weight bearing Quadriceps muscles are key to strengthen in PCL rehabilitation

Prognosis Combined injuries take longer to heal due do surgical necessity, but generally the outcomes are good with conservative treatment