PCL Tear

A PCL (posterior cruciate ligament) tear is an injury to one of the major ligaments that stabilize the knee joint. The PCL is located in the back of the knee and prevents the shinbone (tibia) from sliding backward relative to the thighbone (femur). While less common than ACL tears, PCL injuries can cause significant knee instability and pain.

PCL tears typically occur from direct trauma to the front of the knee while it's bent, such as hitting the dashboard in a car accident or falling on a bent knee. They can also result from hyperextension injuries or sports-related contact. Unlike ACL tears, many PCL injuries can be managed non-surgically, though severe tears or those causing persistent instability may require reconstruction.

At Mountain Spine & Orthopedics, our sports medicine specialists use advanced diagnostics including physical examination, X-rays, and MRI to assess PCL injuries and determine the best course of treatment to restore knee stability and function.

• Knee pain, often in the back of the knee or deep within the joint
• Swelling that may develop gradually
• A feeling of instability or that the knee may give way, especially when going down stairs or slopes
• Difficulty bearing weight or walking
• Stiffness and reduced range of motion
• Pain that worsens with activities that stress the PCL, such as squatting or kneeling
• In some cases, the knee may feel 'loose' or unstable

Several factors increase the risk of PCL tears:

• Direct trauma to the front of the bent knee, such as in motor vehicle accidents
• Falling on a bent knee, particularly in sports like football or soccer
• Hyperextension injuries that force the knee beyond its normal range
• Participation in contact sports or high-impact activities
• Previous knee injuries that may have weakened the ligament
• Certain anatomical factors that may predispose to PCL injury

Diagnosis begins with a comprehensive physical examination, including specific tests like the posterior drawer test and posterior sag test to assess PCL integrity and knee stability. Our specialists also evaluate for associated injuries to other ligaments, menisci, or cartilage.

We offer a complimentary MRI review, as MRI is essential for accurately visualizing the PCL tear and identifying any associated injuries. X-rays may also be used to assess for bone avulsions (where the ligament pulls off a piece of bone) or other structural issues.

Non-Surgical Treatment Options

Many PCL tears, particularly partial tears or isolated injuries, can be managed non-surgically. Treatment includes physical therapy referrals to strengthen the quadriceps muscles (which help compensate for PCL deficiency), bracing for stability, and activity modification to avoid positions that stress the PCL.

Surgical Treatment Options

For severe PCL tears, combined ligament injuries, or cases where non-surgical treatment fails to provide adequate stability, PCL reconstruction may be recommended. This procedure uses a graft to rebuild the torn ligament and restore knee stability, typically performed using minimally invasive arthroscopic techniques.

PCL tear pain is often less severe initially than ACL tears, and some patients may not experience significant pain at all. When present, pain is typically felt deep in the back of the knee or within the joint itself.

The pain may worsen with activities that stress the PCL, such as going down stairs, squatting, or kneeling. Some patients describe a feeling of the knee being 'loose' or unstable, particularly when the foot is planted and the body moves forward over the knee. Our treatment approach addresses both the instability and any associated pain to restore function and confidence in the knee.

While not all PCL injuries can be prevented, several strategies can help reduce risk:

• Using proper safety equipment, such as seatbelts and airbags in vehicles
• Practicing safe landing and cutting techniques during sports
• Maintaining strong quadriceps muscles to help stabilize the knee
• Avoiding activities that place excessive stress on the PCL
• Using proper technique when squatting or kneeling
• Seeking prompt treatment for knee injuries to prevent complications

If you've experienced a knee injury and suspect a PCL tear, schedule a consultation with Mountain Spine & Orthopedics today. Benefit from a complimentary MRI review and expert evaluation to determine the best treatment approach for your injury. Same-day and next-day appointments are often available.