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Posterior Crutiate Ligament Repair
Posterior Crutiate Ligament (PCL) Repair
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 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- These injuries are also called “motor vehicle injuries” and usually occur when the person hits on the dashboard, either while driving or sitting in the passenger seat. In such a position the needs of the person are flexed, so the knee(s) slam against the dashboard which pushes the Tibia bone along the backside of the knee joint leading the posterior cruciate ligament to tear.
- Sports injuries- This type of surgery is common in sportspersons are athletes playing football or soccer. This happens while playing and falling forward which causes the Shinbone to hit the ground and then move backward causing the PCL to tear up.
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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. Rahul Bade is a highly renowned and one of the best Arthroscopic surgeons in Pune with experience of more than 12 years in this field. Being a meritorious student, Dr. Bade has accomplished thousands of Arthroscopic surgeries under his expertise.