Posterior Cruciate Ligament Sprain

Question 1

What is more common ACL tear or PCL tear?

Answer 1

1. ACL

Question 2

How does a PCL tear happen?

Answer 2

1. Knee will be in a flexed position and the force is applied to the tibia driving it posteriorly
2. Due to hyperflexion, especially if the foot is in plantar flexion

Question 3

What is the purpose of a PCL?

Answer 3

1. To prevent the tibia from sliding posteriorly in comparison to the femur

Question 4

What does the PCL attach to?

Answer 4

1. The medial aspect of the medial femoral condyle

Question 5

How will a patient present with a PCL tear?

Answer 5

1. Knee pain
2. Swelling
3. Decreased ROM

Question 6

Does the patient usually complain about instability?

Answer 6

1. No
   *so the PCL tear wont usually need surgery

Question 7

How to test for a PCL tear>

Answer 7

1. Posterior drawer test
   *knee flexed at 45-90 degrees
   *pressure is then applied to the tibia
   + if there is increased posterior movement of the tibia relative to the femur
2. PCL sag

Question 8

What is the PCL sag?

Answer 8

1. Have the knee flexed/foot resting on table
2. Tibia will look like nothing is holding it up and there will be an indentation

Question 9

What labs to order>

Answer 9

1. X-rays
   *the posterior edge of the tibia should line up with the femoral condyles IF NOT then there is a PCL tear
2. MRI
   *more clearly diagnose

Question 10

What is the treatment?

Answer 10

1. Controversial
2. Crutches/ice/elevation
3. PT (quad focus to provide anterior pull)

Question 11

When can a patient return to activity

Answer 11

1. Once FROM is regained (80%) and full strength

Question 12

When is surgery indicated?

Answer 12

1. If there were multiple ligaments torn

***PCL tears are usually not treated with surgery due to the location of the PCL, and PCL grafts stretch out and become less functional