The PCL is one of the largest and strongest ligaments in the knee. It helps keep the knee stable and controls its movement. The PCL is made up of two different bundles:

• Anterolateral Bundle: This part helps prevent the tibia (shin bone) from moving too far forward relative to the femur (thigh bone).
• Posteromedial Bundle: This part helps stop the tibia from rotating too much.

PCL injuries usually occur from a strong, sudden impact or movement, such as:

• Falling on a bent knee
• Car accidents where the knee hits the dashboard
• Jumping or landing awkwardly in hyperextension

Isolated PCL tears are not very common on their own; they often happen along with injuries to other knee ligaments.

What Are the Symptoms?

If you have a PCL injury, you might experience:

• Severe pain in back of the knee
• Swelling in the knee
• Difficulty straightening your knee or lifting your leg
• Trouble putting weight on the leg
• Sensations of instablity

How is a PCL Injury Diagnosed?

To diagnose a PCL injury, doctors use:

1. Physical Examination: The shin bone can be sagging back further than normal making it clear that there is a PCL tear in some cases. Otherwise, we perform a Posterior Drawer test, pushing on the shin bone when the knee is at a 90-degree angle and seeing if there is any instability.
2. X-rays: To rule out fractures or injuries to the kneecap
3. MRI: To see the extent of the injury and check for damage to other parts of the knee.

Special tests like kneeling stress X-rays can measure how well the PCL is functioning and help determine the exact type of injury.

Types of PCL Injuries

PCL injuries are classified into three grades based on severity:

1. Grade 1 PCL Injury:
   • Description: A small partial tear or The ligament is stretched but not completely torn.
   • Treatment: Rest, physical therapy, and bracing. Usually, the knee remains relatively stable.

1. Grade 2 PCL Injury:

1. • Description: A moderate or complete isolate tear. This can cause some instability.
   • Treatment: May include physical therapy, bracing, and possibly surgery.

1. Grade 3 PCL Injury:

1. • Description: A complete tear. The ligament is fully ruptured, causing significant instability and often affecting other knee ligaments.
   • Treatment: Typically requires surgery to repair or reconstruct the PCL, followed by rehabilitation and physical therapy.

If you don’t treat a PCL injury, it can cause several long-term problems for your knee. Here’s what can happen:

1. Chronic Knee Instability:
   • Your knee may feel like it is shifting when you walk or play sports

1. Further Damage:

1. • Additional Injuries: An untreated PCL injury can lead to more damage to other parts of the knee, such as ligaments, the meniscus (cartilage), or cartilage. This can make the knee even more unstable and less functional.

1. Osteoarthritis:

1. • Increased Risk: Over time, an untreated PCL injury can increase the chance of developing osteoarthritis, especially in the patellofemoral area (under the kneecap) and in the medial (inner side) compartment. The instability and altered knee mechanics can speed up cartilage breakdown, leading to pain, swelling, and reduced joint movement.

1. Reduced Quality of Life:

1. • Impact on Daily Activities: Chronic pain and limited mobility can make it hard to do everyday activities and participate in sports, reducing your overall quality of life.