What It Is

The Posterior Cruciate Ligament (PCL) is one of the four main ligaments in the knee that connects the thigh bone (femur) to the shinbone (tibia). It plays a crucial role in stabilizing the knee, particularly in preventing the tibia from moving too far backward. PCL injuries are less common than ACL injuries and typically occur due to a direct impact to the front of the knee, such as during a fall or car accident.

Signs & Symptoms

  • Pain and swelling in the knee, particularly at the back
  • A feeling of instability or looseness in the knee
  • Difficulty walking or bearing weight
  • Limited range of motion, especially with bending the knee
  • A sensation of the knee “giving out” when trying to move

Diagnosis

To diagnose a PCL injury, Dr. Romanelli will perform a detailed physical examination to assess the stability of the knee. Specific tests, such as the posterior drawer test, may be used to evaluate the integrity of the PCL. Imaging, including X-rays or an MRI, is typically recommended to confirm the injury and rule out damage to other structures, such as cartilage or other ligaments.

Treatment

The treatment plan for PCL injuries depends on the severity of the injury. Mild to moderate injuries (partial tears) often respond well to non-surgical approaches, while severe injuries (complete tears) or injuries combined with damage to other ligaments may require surgical intervention.

Non-Surgical Treatment

Non-surgical treatment is usually recommended for partial PCL tears or for patients with less active lifestyles. Non-surgical options include:

  • Rest, Ice, and Elevation: Managing pain and swelling through rest and applying ice packs.
  • Knee Bracing: A brace may be used to stabilize the knee and protect it during healing.
  • Physical Therapy: Strengthening the muscles around the knee, particularly the quadriceps, can help restore stability and function to the knee without surgery.

Surgical Procedure

Surgery may be necessary for complete PCL tears or for those who need to return to a high level of activity, such as athletes. During PCL reconstruction, Dr. Romanelli will use a tissue graft—often from a donor or another part of the body—to replace the damaged ligament. The goal of the surgery is to restore knee stability and prevent future complications. In some cases, PCL surgery may be combined with other ligament repairs, depending on the extent of the injury.

Physical Therapy

Rehabilitation after a PCL injury, whether treated surgically or non-surgically, is essential for full recovery. Physical therapy focuses on restoring strength, flexibility, and range of motion in the knee. Dr. Romanelli works closely with physical therapists to develop a customized rehabilitation plan designed to help patients recover quickly and safely, ensuring a return to normal activities with a stable and functional knee.