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Posterior cruciate ligament (PCL) injury - aftercare

Description

A ligament is a band of tissue that connects bone to bone. The posterior cruciate ligament (PCL) is located inside your knee joint and connects the bones of your upper and lower leg.

A PCL injury occurs when the ligament is stretched or torn. A partial PCL tear occurs when only part of the ligament is torn. A complete PCL tear occurs when the entire ligament is torn into two pieces.

Alternative Names

Cruciate ligament injury - aftercare; PCL injury - aftercare

More About Your Injury

The PCL is one of several ligaments that help keep your knee stable. The PCL helps keep your leg bones in place and allows your knee to move back and forth. It is the strongest ligament in the knee. PCL tears often occur as a result of a severe knee injury.

Injuring the PCL takes a lot of force. It can occur if you:

  • Get hit very hard on the front of your knee, such as hitting your knee on the dashboard during a car accident
  • Fall hard on a bent knee
  • Bend the knee too far backward (hyperflexion)
  • Land the wrong way after jumping

PCL injuries commonly occur with other knee damage, including injuries to the nerves and blood vessels. Skiers and people who play basketball, football, or soccer are more likely to have this type of injury.

What to Expect

With a PCL injury, you may have:

  • Mild pain that may get worse over time
  • Your knee is unstable and can shift as if it "gives way"
  • Knee swelling that starts right after the injury
  • Knee stiffness due to swelling
  • Difficulty walking

After examining your knee, your doctor may send you to have an MRI. An MRI is a device that can take pictures of the tissues inside your knee. The pictures will show whether these tissues have been stretched or torn. You also may have an x-ray to see if there is any damage to the bones in your knee.

If you have a PCL injury, you may need:

  • Crutches to walk until the swelling and pain get better
  • A brace to support and stabilize your knee
  • Physical therapy to help improve joint motion and leg strength
  • Surgery to rebuild the PCL and possibly other tissues in the knee

If you have a severe injury, such as a knee dislocation, you will need knee surgery to repair the joint. For milder injuries, you may not need surgery. Some people can live and function normally with a torn PCL. However, if you are younger, having a torn PCL may lead to arthritis symptoms as you age. Talk with your doctor about the best treatment for you.

Self-care at Home

Follow R.I.C.E. to help reduce pain and swelling:

  • Rest your leg and avoid putting weight on it.
  • Ice your knee for 20 minutes at a time, 3 to 4 times a day.
  • Compress the area by wrapping it with an elastic bandage or compression wrap.
  • Elevate your leg by raising it above the level of your heart.

You can use ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) to reduce pain and swelling. Acetaminophen (Tylenol) helps with pain, but not swelling. You can buy these pain medicines at the store.

  • Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
  • DO NOT take more than the amount recommended on the bottle or by your provider.

Activity

If you have surgery to repair your PCL:

  • You will need physical therapy to regain the full use of your knee.
  • Recovery can take at least 6 months.

If you do NOT have surgery to repair your PCL:

  • You will need to work with a physical therapist to lessen swelling and pain and regain enough strength in your leg to resume activity.
  • Your knee will likely be placed in a brace and may have restricted motion.
  • It may take a few months to recover.

When to Call the Doctor

Call your health care provider if:

  • You have an increase in swelling or pain
  • Self-care does not seem to help
  • You lose feeling in your foot
  • Your foot and leg feels cold or changes color

If you have surgery, call the doctor if you have:

  • A fever of 100°F (38°C) or higher
  • Any drainage from the injection or incision site
  • Bleeding that will not stop

References

Adib F, Curtis C, Bienkowski P Micheli LJ. Posterior cruciate ligament sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 76.

Petrigliano FA, Montgomery SR, Johnson JS, McAllister DR. Posterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 99.

Review Date:5/9/2015
Reviewed By:C. Benjamin Ma, MD, assistant professor, chief, sports medicine and shoulder service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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