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EDUCATION CENTER: Therapies

PCL Reconstruction

Overview
Reviewed by Dr. Jack Farr

Posterior Cruciate Ligament (PCL) reconstruction replaces an injured or insufficient Posterior Cruciate Ligament. The ligament is one of two cruciate ligaments located in the notch between the femoral condyle. It is named by the attachment to the tibia, that is posterior to the anterior cruciate ligament. The PCL runs from the front of the thighbone (femur) notch to the back of the shinbone (tibia). The PCL ligament is more rarely injured than the ACL. The PCL is most often injured by a direct frontal blow to the knee while it is bent. PCL injuries often coincide with injuries that dislocate the kneecap or damage other ligaments.

Detailed Description
Specialist
Orthopedic surgeon

Diagnosis

1. The doctor will perform various hands-on tests to determine the degree that the knee wobbles and the range of motion it allows, and to rule out other injuries that may require surgery. He or she may also order diagnostic x-rays, MRIs, and rarely blood or urine tests to check for possible abnormalities.
2. At times, the PCL injury may heal with adequate stability. Depending on the severity of the injury, the doctor may order the patient to use crutches or wear a movement-restricting knee brace to protect the ligament while it heals. If the doctor decides that the PCL tear is too extensive to heal on its own, or is healing with too much laxity (looseness), he or she will discuss surgery, including different PCL graft possibilities, with the patient and gain consent.
3. Delicate nerves and vascular structures are in the back of the knee. PCL reconstruction requires careful attention to detail and precise surgical technique.
4. There remains a debate in the Orthopaedic community as to an exact indication for surgical intervention. Only the surgeon and the patient can review the individual specifics and make a case by case decision.

During the procedure:
The patient is anesthetized and arthroscopy is performed to assess the condition of the PCL and prepare the inside of the knee. Then with a accessory incisions the graft is positioned to reduplicate the function of the original PCL and firmly fixed to bone using a variety of devices.

Recovery
Hospitalization: Outpatient to 3 nights
At home: Several days

  • Use crutches or a brace to walk until your doctor says otherwise.
  • Wear comfortable shoes.
  • Stay within your safe range of motion as directed by your doctor.
  • Bathe and shower as usual three days after surgery. (unless your surgeon directs otherwise)
  • Ice the knee.
  • Avoid active sports. Restrictions may last up to 9-12 months after surgery.

    Complications/Risks

  • Blood clots (very rare)
  • Surgical wound infection
  • Risk of developing arthritis
  • Weakening of muscles
  • Persistence of Looseness

    Medications
    Prescription and non-prescription pain relievers.

    Follow up with your doctor if:
    Pain, swelling, redness, drainage or bleeding increases in the knee. Also if you experience any symptoms suggestive of infection such as general malaise (tiredness) or fever.

    Last updated: 28-Feb-03


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