Overview of a PCL Injury
The posterior cruciate ligament, or PCL, is the strongest ligament of the knee. While the anterior cruciate ligament, or ACL is injured more often than the PCL and is more commonly discussed, PCL injuries account for more than 20% of reported knee injuries. Because the ACL sits just in front of the PCL, injuries to the PCL are commonly missed and left undiagnosed.
The posterior cruciate ligament’s most important function is to prevent posterior translation of the knee at higher knee flexion angles. Thus, patients commonly complaining of problems with deceleration, problems going down stairs and inclines or general twisting, turning or pivoting activities.
PCL injuries are classified according to the amount of injury to the functional ligament:
- Grade I: partial PCL tear
- Grade II: near complete PCL tear
- Grade III: a complete PCL tear – the ligament is non-functional
PCL Surgery Overview
In general, Dr. LaPrade will perform a PCL reconstruction on all injuries that present themselves as a grade III. In a higher level athlete, it may be recommended to proceed with a PCL reconstruction sooner because the results of acute reconstructions are much better than chronic reconstructions.
When Dr. LaPrade does find that a patient needs a surgical PCL reconstruction, he thoroughly assesses the patient to see if there is a concurrent injury. In our hands, approximately 90% of patients who have a symptomatic PCL tear limiting their function also have a posterolateral corner, posteromedial injury or other associated injury. Thus, the incidence of isolated PCL reconstructions in our own series is approximately 10% of the total PCL reconstructions performed.