Posterior Cruciate Ligament (PCL) Injury

Last updated 20.05.13

 

Index

 

Definition

-  Injury to the posterior cruciate ligament of the knee joint

 

Features

-  Better healing capacity than ACL

 

Cause

-  Fall onto knee with impact to anterior tibia

 

Associated S/S

-  Pain

-  Antalgic gait, limp

-  Instabililty when descending stairs or walking downhill

-  Knee examination

-  Rapid swelling, erythema, warmth

-  Stiff joint

-  Bruising

-  Haemarthrosis

-  Posterior sag of tibia on femur

-  90% sensitivity, 99% specific

 

DDx

-   

 

Grades

-   

 

Ix

-  AP Draw Test: tibia displaces posteriorly on femur

-  79% sensitivity, 100% specific

-  MRI

-  Out-of-pocket if referred by LMO but may expediate referral & reduce overall costs

-  Dx of degree of injury

-  Associated injuries: meniscal tears, bone bruising or avulsion, damage to posterolateral corner structures

 

Mx

-  Analgesia

-  RICE

-  Isolated ruptures managed conservatively

-  Immobilisation

-  Long hinged knee brace

-  Rehabilitation: 6-10weeks

-  Referral

-  Ruptures to Ortho or Sports physician

-   +/- MRI prior

-   To exclude occult injuries

-   Appropriate splinting

-  Sprains can be managed without referral unless complications

 

 

 

References

 

Sports Knee Injuries: Assessment & Mangement, AFP Vol 39, No 1/1 2010