A PCL or Posterior Cruciate Ligament surgery is a reconstructive surgery that is performed after a PCL injury. If you have sharp pain at the backside of the knee joint, it’s probably time to visit a good Orthopedic surgeon.

What is PCL?

The knee joint comprises the two most important ligaments that help in stabilizing the knee joint. These ligaments are called cruciate ligaments and connect the thigh bone (Femur) with the shin bone (Tibia). There are two types of cruciate ligaments- anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Both of these cruciate ligaments together make an “X” pattern that helps in stabilizing the knee joint from front-to-back and back-to-front directions. The PCL helps in preventing going too far in comparison with the upper leg during knee flexion.

PCL-Reconstruction

What Are PCL Injuries?

A PCL injury occurs when the PCL is overstretched or has a tear in it. This is a relatively rare injury as compared to the ACL injury.

Causes/Etiology

  • Dashboard Injuries

  • Sports injuries

Complications

Sometimes while the accident happens The other structures of the knee joint such as cartilage, or other ligaments involved also get damaged. This may lead to restricted movements​ and pain. Depending upon the number of structures involved and the grade of injury, the severity of the damage is estimated. More damage can render the knee unstable and lead to a higher risk of developing arthritis.

Grades of PCL Injury

There are four grades of a PCL injury depending upon the amount of severity-

  • Grade I- In this grade of injury, there​ are microscopic tears in the ligament which may bend the PCL out of shape. The weight-bearing capacity of the knee joint is not lost in this grade of injury.
  • Grade II- In this grade of injury, the PCL gets torn up partially and the knee joint also becomes unstable. The knee joint may come out frequently while walking and standing.
  • Grade III- This grade injury involves a complete tear of the PCL with its separation from the bony parts where it is attached. In this type of injury, the knee joint becomes highly unstable and is not able to bear the body weight. 

Grade IV- Sometimes with the PCL, other structures of the knee joint are also damaged. This typically leads to a highly unstable knee joint and other complications.

Symptoms

Following are the symptoms of a PCL injury and if you are observing one, you should consider consulting a good Orthopedic surgeon-

  • Feeling of the knee becoming “loose”.
  • Inflammation.
  • Pain in the knee joint especially while walking or bending forward.

The symptoms of a sprain may resemble a PCL Injury, so consulting a doctor after observing the above symptoms is a prerequisite.

How Is a PCL Injury Treated?

In the starting, the fundamental treatment for all grades of PCL injuries is following the rule of RICE (Rest, Icing, Compression, and Elevation). The further treatment of the PCL depends upon the severity and grade of the injury.

  • Grade I and Grade II Injuries- In these grades, the knee joint will be supported by a splint to maintain a straight leg position. Along with this, the rehabilitation program and physiotherapy are also started to strengthen the ligament and for preventing​ further knee injury. 
  • Grade III Injuries- In the Grade III injury of the PCL, reconstruction surgery is recommended. If the PCL is detached from the attachment point, it can be screwed back into place. If the PCL is completely ruptured, it can be repaired with a piece of your tissue (autograft) or a piece of donor tissue (allograft). This surgery is performed by an experienced Arthroscopic surgeon only. 

Dr. Biren Nadkarni is a highly renowned and one of the best Arthroscopic surgeons​ in Delhi with experience of more than 20 years in this field. Being a meritorious student, Dr. Biren has accomplished thousands of Arthroscopic surgeries under his expertise.

How is PCL Reconstruction Surgery Done?

At Joint & Bone Solutions, Dr. Biren Nadkarni, the best Arthroscopic surgeon in Delhi, examines his patients deeply before proceeding further. At Grade III only, surgery is recommended. At our clinic, we encounter a higher ratio of patients with multiple PCL and associated injuries, such as posteromedial or posterolateral injuries. Dr. Biren Nadkarni holds significant experience in treating PCL injuries using arthroscopic techniques​. Arthroscopic surgery is a minimally invasive surgery in which Dr. Biren makes very small incisions around the knee joint and inserts a very narrow fiber optic scope (Arthroscope) to analyze and examine the condition of the injury. 

The surgery further proceeds with tiny instruments that are utilized for removing the damaged ligament and replacing it with the fresh one. Dr. Biren takes utmost care while going on with the next step of drilling holes in the thigh and the shin bone for accurately positioning the graft. The next step consists of anchoring the graft using screws or other fixating devices. The graft can be derived from the patient himself (autograft) or it can be obtained from another person (allograft). The use of the type of ligament depends upon the person’s needs and requirements.

Post Operative Care

Post-operative care after a PCL injury includes Physiotherapy, proper care, and medications. It is highly recommended to consult a physiotherapist for a detailed rehabilitation program and day/weeks care.

How Long Does it Take to Recover After a PCL Injury?

It usually takes 6-9 months to completely​ recover from the injury and returning to sports activity. To regain knee strength and a full range of motion, it is advised to go for a rehabilitation program under a physiotherapist. One can go for weight-bearing activities after being guided by the surgeon.