Posterior Cruciate Ligament Injury
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Definition
The posterior cruciate ligament (PCL) is connective tissue located within the knee. The PCL connects the thighbone to the shinbone. This connection keeps the shinbone from moving too far backward, stabilizing the knee.

Posterior Cruciate Ligament

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Causes
The PCL ligament can become strained or torn when a strong force is applied to it. This force can occur during sports or other high-stress activity.

Risk Factors
Factors that may increase your chance of injuring the PCL include:

  • Sports injury
  • Motor vehicle accident
  • Fall on a bent knee
  • Strong force to the leg immediately below the kneecap
  • Knee dislocation
Symptoms
A PCL tear may cause:

  • Pain and swelling in the knee
  • Soreness in the area behind the knee
  • Weakness or instability in the knee
  • Difficulty walking
  • Pain when moving the knee
Diagnosis
You will be asked about your symptoms and medical history. A physical exam will be done.

Images may need to be taken of the internal structure of your knee. This can be done with:

Ligament sprains are graded according to their severity:

  • Grade 1—Mild ligament damage
  • Grade 2—Partial tearing of the ligament
  • Grade 3—Complete tearing of the ligament
Treatment
Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

Supportive Care
Your ligament will need time to heal. RICE is often the main part of treatment:

  • Rest—Activities may need to be restricted at first. Normal activities will be gradually reintroduced.
  • Ice—Ice therapy may help relieve swelling. Heat or cold may be recommended throughout recovery if they provide benefits.
  • Compression—Used for a limited time, compression bandages can provide gentle pressure to help move fluids out of the area.
  • Elevation—Keeping the area elevated can help fluids drain out or prevent fluids from building up.
Your doctor may recommend a knee brace to stabilize the knee, and crutches to keep extra weight off your leg.

Prescription or over-the-counter medications may be advised to reduce pain.

Physical Therapy
A physical therapist will assess your knee. An exercise program will be created to help recovery and to strengthen the muscles.

Surgery
Surgery may be needed to fully restore function of the knee. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and associated factors.

Prevention
Some steps that may help decrease your chance of getting a PCL injury include:

  • Protect your knees by doing regular strengthening exercises for your thighs.
  • Maintain proper technique when exercising or playing sports.



RESOURCES:
American Orthopaedic Society for Sports Medicine

OrthoInfo—American Academy of Orthopaedic Surgeons

CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
Knee sprains and meniscal injuries. Merck Manual for Health Care Professionals. Available at: http://www.merckmanuals.com/professional/injuries_poisoning/fractures_dislocations_and_sprains/knee_sprains_and_meniscal_injuries.html. Updated December 2014. Accessed March 9, 2015.

Ligament injuries to the knee. John Hopkins Medicine website. Available at. http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic_disorders/ligament_injuries_to_the_knee_85,P00926/. Accessed March 9, 2015.

Posterior cruciate ligament injuries. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00420. Updated February 2009. Accessed March 9, 2015.

Posterior cruciate ligament (PCL) injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 14, 2014. Accessed March 9, 2015.

10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

Last Reviewed March 2015



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