Learn More About Your Painful Knee Condition Below
The posterior cruciate ligament (PCL) is a ligament in each knee of humans and various other animals. It works as a counterpart to the anterior cruciate ligament (ACL). It connects the posterior intercondylar area of the tibia to the medial condyle of the femur. This configuration allows the PCL to resist forces pushing the tibia posteriorly relative to the femur.
The PCL and ACL are intracapsular ligaments because they lie deep within the knee joint. They are both isolated from the fluid-filled synovial cavity, with the synovial membrane wrapped around them. The PCL gets its name by attaching to the posterior portion of the tibia.
The PCL, ACL, MCL, and LCL are the four main ligaments of the knee in primates.
Common causes of injuries are direct blows to the flexed knee, such as the knee hitting the dashboard in a car accident or falling hard on the knee, both instances displacing the tibia posterior to the femur.
An additional test of posterior cruciate ligament injury is the posterior sag test, where, in contrast to the drawer test, no active force is applied. Rather, the person lies supine with the leg held by another person so that the hip is flexed to 90 degrees and the knee 90 degrees. The main parameter in this test is step-off, which is the shortest distance from the femur to a hypothetical line that tangents the surface of the tibia from the tibial tuberosity and upwards. Normally, the step-off is approximately 1 cm, but is decreased (Grade I) or even absent (Grade II) or inverse (Grade III) in injuries to the posterior cruciate ligament. The posterior drawer test is one of the tests used by doctors and physiotherapists to detect injury to the PCL. Patients who are suspected to have a posterior cruciate ligament injury should always be evaluated for other knee injuries that often occur in combination with an PCL injuries. These include cartilage/meniscus injuries, bone bruises, ACL tears, fractures, posterolateral injuries and collateral ligament injuries.
There are four different grades of classification in which medical doctors classify a PCL injury:
Grade I, the PCL has a slight tear.
Grade II, the PCL ligament is minimally torn and becomes loose.
Grade III, the PCL is torn completely and the knee can now be categorized as unstable.
Grade IV, the ligament is damaged along with another ligament housed in the knee (i.e. ACL).
With these grades of PCL injuries, there are different treatments available for such injuries.
It is possible for the PCL to heal on its own. Even if the PCL does not heal normally, it is unusual for surgery to be required. Treatment is usually physiotherapy to strengthen the muscles around the knee; usually they provide adequate stability even without a functional PCL. Only if there are ongoing symptoms down the track, or if there are other injuries in the knee (eg posterolateral corner injury) will ligament reconstruction be required. Ligament reconstruction is used to replace the torn PCL with a new ligament, which is usually a graft taken from the hamstring or Achilles tendon from a host cadaver. An arthroscope allows a complete evaluation of the entire knee joint, including the knee cap (patella), the cartilage surfaces, the meniscus, the ligaments (ACL & PCL), and the joint lining. Then, the new ligament is attached to the bone of the thigh and lower leg with screws to hold it in place. Surgery to repair the posterior cruciate ligament is controversial due to its placement and technical difficulty. Proper foot support via custom fitted shoe insoles or orthotics can by crucial in prevention and in pain relief.
Best Feet professionally fit orthotic shoe arch supports provide immediate pain relief related to this condition. Our pain relief experts are here for you with a free evaluation and balance test with no obligation. Don’t live in pain, book online, call or just walk in for same-day relief!
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