Knee
Posterior cruciate ligament tear
by Uperform
When the PCL undergoes direct or indirect violent trauma, it can rupture and no longer perform its functions. However, it is rarer than that of the ACL (1 LCP for 5 ACL).
1) A LITTLE ANATOMY:
The knee is a complex joint. The knee joint is made up of 3 bones: the upper femur, the lower tibia and the patella, a small mobile bone in front of the knee. During flexion/extension movements of the knee, the patella slides on the femur.
This knee is notably composed of 4 ligaments that play an essential role in controlling movement. We first find the so-called “cruciate” ligaments including the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL), then the medial collateral ligament, and finally the lateral collateral ligament.
2) WHAT IS THE LCP DAMAGE, AND WHAT ARE THE DAMAGE MECHANISMS?
When the PCL undergoes direct or indirect violent trauma, it can rupture and no longer perform its functions. However, it is rarer than that of the ACL (1 LCP for 5 ACL).
The mechanisms of injury are as follows:
Violent trauma (fall) during sports practice: pivot sports, skiing, etc.
A brutal impact on the tibia during a combat sport: MMA, taekwondo, …
A shock leaning on the knee while it was in full extension (rarer).
3) WHAT ARE THE SYMPTOMS?
In case of rupture of the PCL, several symptoms can occur just in the hours following the trauma:
Pains
Swelling
Instability
Decreased joint mobility
Temporary blockage of the knee
However, two things can cause problems:
The PCL injury is regularly accompanied by other ligament or cartilage injuries, increasing the risk of future pathologies.
This lesion often goes unnoticed and the diagnosis is made late, which can have harmful consequences for the patient.
Clinical examination and medical imaging (MRI) can determine the severity of the lesion. This also makes it possible to observe any associated lesions, which will have an impact on the healing time and the therapeutic choice.
4) IS SURGERY MANDATORY?
Depending on the clinical picture, surgery may be offered as a treatment option. This is particularly effective in the case of complex and/or associated lesions.
It is also mainly offered to young and athletic populations, in particular to athletes practicing sports with specific movements including significant changes of direction and pivots.
Surgical intervention makes it possible to improve the stability of the knee, and therefore reduces the risk of pathologies resulting from this instability in the future (osteoarthritis, meniscal lesion, etc.).
Conservative treatment can, however, be offered to patients whose sporting objective is less, or when they have a lower level of activity.
5) HOW DOES THE REHABILITATION TAKE PLACE?
Conservative and post-operative treatment are similar on many points. The difference will mainly be in the first days following the possible surgery.
While respecting the healing process, the work will focus on:
Recovery of normal joint amplitudes
Gradual rehabilitation of the joint
Recovery of a correct gait pattern
Overall muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athleticization and rehabilitation in the sporting gesture
The rehabilitation of the PCL follows an evolution based on skills criteria evaluated by means of tests, as well as on time criteria in order to respect the healing and the ligamentization of the graft.
6) CAN I CONTINUE TRAINING?
Initially, stopping sporting activity is most of the time essential in order not to aggravate the lesion.
Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
Depending on the diagnosis, a plan will be put in place to gradually return to your sporting activity.
7) WILL I RETURN TO MY PRE-INJURY LEVEL?
Provided you follow the instructions and recommendations given by your surgeon and your therapist, you will more than likely find your level in a few months!
However, it will be important to strengthen the knee as well as the lower limbs as a whole in order to avoid relapses.
8) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!