The two tough bands of fibrous tissue that connect the thigh-bone (femur) and the large bone of the lower leg (tibia) at the knee joint are the posterior cruciate ligament(PCL) and the anterior cruciate ligament (ACL). Together, the ACL and PCL bridge the knee joint, forming an “X” pattern that stabilizes the knee against front-to-back and back-to-front forces respectively. In particular, the PCL prevents the lower leg from slipping too far back about the upper leg, especially when the knee is flexed (bent). A PCL injury includes a stretch or tears in the ligament. When the front of the knee hits the dashboard during an automobile accident this often injured the PCL. While doing sports activities, the PCL may occur when an athlete falls forward and lands hard on a bent knee. This is common in football, basketball, soccer and especially rugby.
Two bones that meet to form the knee joint are the thigh-bone (femur) and shin-bone (tibia). Ligaments connect the bones to other bones. In our knee, there are four primary ligaments. They act as a strong rope to hold the bones together and make the knee stable.
Collateral ligaments. These collateral ligaments are found on the sides of the knee. Medial ligaments and lateral collateral ligament are inside and on the outside respectively. These control the sideways motion and also brace the knee against unusual movements.
Cruciate ligaments. These ligaments are inside the knee joint. They are crossed each other to form an X shape with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The back and for motion of the knee is controlled by the cruciate ligaments.
While bending due to blow, the PCL injuries often occur.
Common causes include:
- During an auto accident, the knee may strike against the dashboard
- Falling on the knee while bent
Doctors classify PCL injuries as the following groups:
Grade I: A partial tear in the PCL.
Grade II: The partial tear in the ligament and is looser than in Grade I.
Grade III: The completely torn ligament and the knee becomes unstable.
Grade IV: Along with the another ligament in the knee, PCL is damaged.
Symptoms of a PCL injury may include:
- When you walk or stand, and with or without limitation of motion there will be a mild knee swelling, with or without the knee giving out.
- While kneeling, mild pain at the back of the knee occur
- Pain in the front of the knee while you run or try to slow down
People often think they only have a minor knee problem after a PCL injury. They may try to continue with their usual activities. However, symptoms that can develop during that time may include:
- Swelling over the area (mild to severe)
- Knee pain at the point
- Wobbly sensation
- Walking trouble or bearing weight on the knee
A PCL tear can lead to osteoarthritis in the knee over time.
Treatment for Pcl injuries
For all the grades of PCL injuries, initial treatment follows the RICE rule:
- Give rest to the joint.
- For reducing swelling, Ice the injured area
- Compress the swelling point with an elastic bandage.
- Try to elevate the injured area.
When to see the doctor?
The structures of the injured knee and the non-injured knee is compared by the doctor to check the symptoms. The injured knee may appear to sag backwards when it bent. When it is bent beyond a 90° angle, it might slide back too far. Other tests which may help to confirm the diagnosis may include X-rays and magnetic resonance imaging (MRI).
For further information regarding PCL injury, feel free to contact Dr Madhu Thumu, who is an expert in the diagnosis and treatment of the PCL injury. By assessing the symptoms, he can easily diagnose the problem. Thus, he will suggest the exact treatment regarding the symptoms.