Posterior Cruciate Ligament Injury

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KEY POINTS

• A PCL injury is a stretching or tearing of the strong band of tissue in your knee that connects your thighbone to your shinbone at the back of your knee.
• Change or stop doing the activities that cause pain until the injury heals.
• A PCL injury can be treated with removing fluid, bandages, braces, crutches, ice, exercise, and sometimes with medicine or surgery.

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What is a posterior cruciate ligament injury?

A posterior cruciate ligament injury is an injury to one of the ligaments in your knee. Ligaments are strong bands of tissue that connect one bone to another to form the joints. Your posterior cruciate ligament connects your thighbone to your shinbone at the back of your knee. The ligaments in your knee keep your knee and leg bones in place when you walk or run. When a ligament is injured, it can be stretched, partially torn, or completely torn. Complete tears make your knee joint very loose and unstable.

A ligament injury is also called a sprain.

What is the cause?

A posterior cruciate ligament injury can happen if the front of your shin bone is hit while your knee is bent and your foot is planted on the ground or if your knee hits the dashboard in a car accident. It may also be caused by a sudden activity that twists or tears the ligament, like a fall that bends your knee out of place.

What are the symptoms?

Symptoms may include:

• A loud, painful pop at the time of the injury
• Swelling, tenderness, or pain around your knee
• Trouble bending or straightening your knee
• A feeling that your knee is loose or unstable

If you tore your posterior cruciate ligament months or years ago and you haven't had it repaired with surgery, you may have the feeling that your knee is weak and giving way when you twist or turn.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, activities, and medical history and examine you. You may have X-rays or other scans or procedures, such as an MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your knee joint.

How is it treated?

You will need to change or stop doing the activities that cause pain until the ligament has healed.

If you have swelling in your joint, your healthcare provider may need to remove fluid from your knee with a needle and syringe. Your provider may wrap an elastic bandage around your knee to keep swelling from getting worse.

Complete tears of the PCL may need surgery, especially if other ligaments are also damaged. You may need to wear a brace or keep your knee in a knee immobilizer and use crutches to protect your knee while you heal.

Your healthcare provider may recommend stretching and strengthening exercises to help you heal. You will need to do keep doing rehabilitation exercises to keep your leg muscles strong if your ligament is loose after the injury.

The pain often gets better within a few weeks with self-care, but some injuries may take several months or longer to heal. It’s important to follow all of your healthcare provider’s instructions.

How can I take care of myself?

To keep swelling down and help relieve pain for the first few days after the injury:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time.
• Keep your knee up on a pillow when you sit or lie down.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Follow your healthcare provider's instructions, including any exercises recommended by your provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a posterior cruciate ligament injury?

Warm-up exercises and stretching before activities can help prevent injuries. For example, do exercises that build strong thigh and hamstring muscles and stretch your leg muscles.

Follow safety rules and use any protective equipment recommended for your work or sport. For example, if you ski, be sure your ski bindings are set correctly by a trained professional so that they will release if you fall.