Situations in which pcl can tear (injury occured when ) include

• excessive hyperflexion (forced bending) or
• falling onto the shin with a bent knee.
• dashboard injury in a car where the knee is bent to a right angle and a sudden force drives the tibia backwards( the pcl takes the strain).

Often other ligaments are torn at the same time and the symptoms related to them usually dominate the history.

Isolated pcl tears cause pain, swelling, and limited range of motion

Often the ligament does not actually tear through its substance but rather it gets pulled off its bony attachment above or below (avulsion).

The posterior drawer test allows the diagnosis. It is performed with the patient lying flat and relaxed. The knee is bent 90°. By pushing the shin backward, the integrity of the pcl is tested. Excessive movement of the shin (compared with the other knee) is a sign of pcl injury.

MRI will access the tear and explore the other elements (medial and lateral collateral ligaments, meniscus and even the acl.

The treatment is usually physiotherapy rehabilitation techniques. Early surgery is rarely required except if other ligaments are torn (Lateral collateral ligament +++ or medial collateral ligament). In the case of tibial avulsion, it may be required to fix it with internal screws to ensure proper healing.

It may take up to 10 weeks for a pcl injury to return to sport.Sometimes later,the knee develops problems which begins as pain. Instability is rare. In this cases, a pcl reconstruction might be necessary. It is performed arthroscopically also using a graft (hamstring tendons).

Docteur Jean Etienne Perraudin,