PCL Tear - Symptoms, Causes, Prevention, Treatment

The Posterior Cruciate Ligament or PCL runs along the back of the knee, connecting the thigh bone (femur) to the shin bone’s top (tibia). PCL keeps the bones in place and helps the knee in a smooth movement. When the posterior cruciate ligament gets torn or sprained, the condition is known as PCL tear or injury. PCL tears are less common than ACL (anterior cruciate ligament) tears and make up less than 20% of all injuries to knee ligaments. Usually, PCL tears occur with other ligament injuries, and isolated tears are even more uncommon.

A PCL tear can happen to anyone. However, it is more common among skiers and athletes who play football, soccer, or baseball. PCL tears usually occur with severe knee trauma. It can also occur if you:-

1. Fall and land on your bent knee
2. Hit the front of your knee hard on something, such as a car’s dashboard
3. Twist or dislocate your knee
4. Bent your knee far too backwards (hyperextension)
5. Land improperly post-jump
6. Dislocate your knee

People with PCL tears may experience the following symptoms:-

1. Worsening knee pain over time
2. Inflammation and swelling
3. Stiffness
4. Feeling instability in the knee
5. Difficulty in walking
6. Trouble bearing weight on the knee
7. Difficulty in going down the stairs
8. Tenderness in the knee
9. Wobbly sensation in the knee

Apart from asking you about your symptoms, the doctor will perform the following tests for the diagnosis of PCL tears:-

1. Physical exam (posterior drawer test): You will lie on your back with your knee bent to 90 degrees. The doctor will move the knee in various directions to check the range of motion. Furthermore, they will examine your knee and press against the upper shin. Any abnormal knee movement during this test indicates a PCL tear. Another sign of a tear in the PCL is when your knee droops backwards while the provider tries to straighten your leg. They may also check you with an arthrometer, a device which presses against your leg to measure the ligament’s tightness. 
2. Imaging tests: The doctor performs an X-ray to gain information about the PCL tears. An X-ray of the knee joint helps detect fractures. 
3. Magnetic resonance imaging (MRI): The test is used to create images of the PCL tear. It identifies the exact location of the tear. 
4. Bone scan: The doctor may perform a bone scan to look for bone damage in chronic PCL tears. 

Non-surgical treatments

1. Knee brace: The doctor may recommend bracing your knee to address instability. Untreated instability can lead to arthritis. 
2. Crutches: You may need crutches to limit weight on the knee and protect the knee. 
3. Physical therapy: It includes specific exercises to help you strengthen your leg muscles around the knee and restore full range of motion in your knee joint. 
4. Home remedies: If you have a PCL tear, there are several ways to manage the condition at home, which include:-
   1. Pain relievers: Take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, to relieve pain and swelling.
   2. Rest: Avoid activities that put unnecessary stress on the knee.
   3. Ice: Apply cold packs to the knee for short periods, about four times a day. 
   4. Compression: Wrap your knee in an elastic bandage to help relieve swelling. 
   5. Elevation: Place your leg on a pillow and elevate your knee so that it’s above your heart level.

The treatment for rebuilding a PCL is generally performed using an arthroscope. The benefits of the treatment include:-

1. There is no wait time, i.e., the doctor can treat the PCL damage as soon as the injury is diagnosed.
2. The treatment for PCL tears usually carries a low risk. 
3. The PCL tear can be treated with minimally invasive surgery. 
4. As a result of minimally invasive surgery, the pain after the surgery is less, and the recovery time is usually shortened. 
5. The PCL tear surgery can repair the most severe tears and multiple ligament injuries. 
6. The surgery can ease the symptoms of a PCL tear, such as an unstable knee.