Posterior Cruciate Ligament (PCL) Tears: Treatment Options

Posterior Cruciate Ligament (PCL) Tears: Treatment Options

The grade of a PCL tear, along with a patient's symptoms, and whether there is also injury to any other structure in the knee, will help a healthcare provider determine the best treatment. Grade 1 tears are mild, microscopic tears, grade 2 are moderate, partial tears, and grade 3 are severe, complete tears.

Generally, nonsurgical treatment including rest, ice, bracing, and physical therapy to improve strength and range of motion, is preferred for grade 1 and grade 2 PCL tears that occur without any other injury. Nonsurgical treatment can also be used for grade 3 tears, but if a grade 3 tear causes significant pain and instability, surgery may be considered.

Surgery for a PCL tear is more likely to be considered for knee injuries involving damage to more than one ligament, especially if the patient is an athlete or very active in sports or exercise that involve jumping and quick changes in direction. If surgery is recommended, the PCL usually cannot be sewn back together, so reconstruction can be performed to replace the damaged ligament with a tendon graft.

The graft can be taken from somewhere else in the patient's body or from a cadaver donor. After surgery is complete, rehabilitation will involve a series of steps over several weeks. This may include wearing a brace to keep the knee straight as the ligament heals, using crutches to stay off the affected leg at first, and then physical therapy to gradually improve range of motion, strength, and balance.

Recovery from PCL reconstruction typically requires at least 6 to 8 months of activity restriction and physical therapy, with an additional 3 to 4 months of conditioning to return to unrestricted physical activity.