Diagnosis |
POSTERIOR CRUCIATE LIGAMENT TEAR
(PCL injury)
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| Definition |
Partial or complete
rupture of the posterior cruciate ligament |
Details |
The posterior cruciate
ligament is located in the back of the knee and is responsible for
limiting backward movement of the shin bone (Tibia) with respect to
the thigh bone (Femur). It is a relatively rare injury that occurs
most often in football players, hockey players and skiers. It may
also result from a car accident. |
Causes |
A tear of the PCL occurs
via two classic mechanisms. The first is falling on a bent knee.
This pushes the shin bone back and tears the PCL. This same
mechanism ruptures the PCL when the knee hits the dashboard in a car
accident. The second mechanism is when the knee is hyperextended
(bent backwards). Finally, the PCL may be torn in conjunction with
the anterior cruciate ligament (ACL) via a violent twisting of the
knee. |
Diagnosis |
PCL injuries are
diagnosed by first attempting to obtain a history of one of the
above mechanisms. The injury may be associated with a
"pop" in the knee and immediate swelling. The physical
exam will show moderate knee swelling and pain with motion. A
variety of maneuvers by your doctor will then be done to elicit the
backward instability of the knee caused by the tear of the PCL.
X-rays are done to rule out fractures. An MRI scan may also be order
to confirm the diagnosis and evaluate the cartilage within the knee.
MRI
of Normal and Torn PCL |
Treatment |
Nonoperative: Most
PCL injuries can be treated with an aggressive physical therapy
dedicated to strengthening the quadriceps and hamstring muscles.
Coordination retraining and bracing also play a role.
Operative: Surgery is usually reserved for severe injuries that
are not responsive to nonoperative treatment. PCL tears that occur
in combination with other ligament injuries may also require
reconstructive surgery. Finally, elite athletes who demand perfect
knee stability may elect to have surgery. |
| Prevention |
Maintain excellent strength and stability of the knee
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