The posterior cruciate ligament (PCL) helps connect the femur to the tibia, also known as the shinbone. Located in the back of the knee, the PCL is typically only injured by an extreme force. PCL reconstruction involves using a graft to repair the injured ligament, and often involves repairing other injured ligaments at the same time.
Causes of PCL injury can range from severe trauma to simple movements. Severe trauma, such as when a knee is injured in a car crash, can lead to more severe injuries and tears. Twisting the knee from a misstep, such as stepping in a hole in the grass, can also cause damage to the various structures of the knee, including the PCL.
A large majority of PCL injuries will not require surgery. Small tears or strains will usually resolve over time with appropriate home care measures. This may include rest, ice, and keeping the knee elevated. Physical therapy may also be recommended to ease back into daily activities, such as walking or athletics. Surgery is typically reserved for the most severe tears, and is often recommended if the PCL is injured in combination with other knee ligaments.
PCL reconstruction surgery is conducted with the use of an arthroscopic instrument. This allows doctors to access the PCL through small incisions in the knee. The surgery itself is minimally invasive due to its arthroscopic nature.
Grafts are required to replace a posterior cruciate ligament. The graft is typically tissue taken from a cadaver or from another area of the patient’s body. Grafts are chosen as the preferred method of PCL reconstruction because of problems experienced with the ability of the PCL to heal itself if sewn back together.
Rehabilitation is an important component of a successful PCL reconstruction. The knee will need to be immobilized for approximately six to eight weeks. Patients with right knee PCL reconstruction will need to refrain from operating a car for eight weeks. Physical therapy to help regain range of motion and strength will be necessary. Return to a desk job is possible approximately two weeks after surgery, depending on progress.
Total recovery time can take six to twelve months. Full participation in rehabilitation and physical therapy recommendations can help speed recovery. Following doctor and physical therapist orders on directions related to returning to work and activity can help minimize the possibility of new damage and possible improper healing of the PCL.