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Sunsoochon Hospital

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Knee

home Knee Posterior Cruciate Ligament (PCL) Tear

Posterior Cruciate Ligament (PCL) Tear

The PCL plays a major role in stabilizing the knee joint, and it is an important structure that plays a primary role (approximately 95%) in preventing the posterior displacement of the tibia. Typically, a simple rupture of the PCL entails conservative treatment of the injury. Recently, however, more patients are electing to undergo a surgical repair of the PCL to help them return to sporting activities at full strength

Diagnosis

ACL tears can be diagnosed with a physical examination and MRI. Physicians often look for other related injuries when diagnosing an ACL tear.
Posterior drawer test
Reverse pivot shift test
정상 후방십자인대
후방십자인대 파열(2도 손상)

Treatment

Non-surgical treatment
If the injury is not severe enough to merit surgically treatment, the patient may be prescribed with rehabilitation exercises, thermal (ice) treatment, compression, HILT laser, and cryotherapy to control swelling, pain, and inflammation. Alternatively, injections (PDRN, Prolo) can be used at the discretion of a specialist to promote ligament healing.
Surgical treatment
For some patients, even a moderate-grade (i.e. grade-2) injury to the PCL alone may lead to severe posterior instability. In such cases, surgical treatment must be considered as an option. As for an injury involving multiple ligament tears, the patient may start to exhibit symptoms of degeneration to the cartilage plate or the cartilage itself due to increased instability over the long-term. These types of injuries are typically treated with surgical reconstructions.

Rehabilitation after the surgical reconstruction of a PCL tear

Early stages (~ week 6)
Patients will be prescribed with light stretching, lymph massage therapy, laser therapy, cryotherapy, and physical therapy.
Patients will be prohibited from active independent contraction (especially OKC movement) of the hamstrings for at least six weeks after the surgery.
Thereafter, patients will be instructed to restore the range of motion in their knee joint, build muscle strength, and recover their proprioceptive senses. Passive range of motion should gradually progress to more than 90 degrees after two weeks. In the 6th week, patients must regain full range of motion of the knee joint.
Week 6 ~
From week-6, patients will be prescribed with isometric hamstring strengthening exercises within the pain tolerance threshold.

Active reinforcement of the hamstring will begin at the discretion of the specialist and therapist (typically three months after the surgery).
Return to sports
Patients will be allowed to return to sporting activities when they score 85% or higher on their isokinetic and functional tests (without experiencing any pain) at least six months after their surgery.
Patients will be allowed to begin light jogging when they reach 70%.

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