Posterior Cruciate Ligament (PCL) Injury – Causes, Systems, and Treatment
Causes of PCL Injuries
Symptoms of PCL Injury:
Diagnosing PCL Injuries
Home Treatments of PCL Injuries
Nonsurgical Treatments of PCL Injury
Treating the PSL Injuries with Surgery
Posterior Cruciate Ligament which is also abbreviated as PCL is a knee ligament. In fact, the ligaments connect the bones with the help of their tough bands of tissues. Posterior Cruciate Ligament is similar to the anterior cruciate ligament (ACL) plays a role to connect the femur (Thigh Bone) to the tibia (shin bone). However, the PCL is larger than ACL that’s why it contains a high risk of getting damage (can be torn).
More than 20 % of the injuries related to knee ligaments are because of the PCL tears. Injuries or damages impacting the PCL usually create troubles for other parts of the ligaments as well as cartilage. In some cases, the ligaments partially or completely break which makes the bones lose.
Causes of Posterior Cruciate Ligament Injuries:
The Posterior Cruciate Ligament Injury usually happens when someone blows the knee while it was bent. Other general causes of PCL injuries are given here.
- During a roadside accident, knees strike against the wall of the dashboard of a car.
- Falling on your knees especially when it’s bent.
The Posterior Cruciate Ligament Injuries are also caused by the sports activities. The PCL injuries are common during the given games.
Categorization of PCL Injuries:
The Posterior Cruciate Ligament Injuries could be mild or severe. It depends on the nature of the damage. Medical experts categorize these injuries in the following groups.
- 1st Grade: If the Posterior Cruciate Ligament is partially damaged.
- 2nd Grade: If the Posterior Cruciate Ligament is partially torn but it is looser than the first grade.
- 3rd Grade: If the ligament of PCL is completely torn. It also makes the knee completely unstable.
- 4th Grade: If the Posterior Cruciate Ligaments and other ligaments of knees are also damaged.
Based on the above-mentioned categories, the Posterior Cruciate Ligament Injuries could be acute or chronic. Sudden injuries are the major cause of acute PCL while an injury making different issues with the passage of time leads to chronic PCL.
Symptoms of Posterior Cruciate Ligament Injury:
After getting a Posterior Cruciate Ligament Injury, most people don’t observe any type of “Popping” sensation. The PCL injuries are more similar to the ACL injuries. In most of the cases, the patients believe that they have a simple or little issue with knees. Most people continue the physical activities after PCL injuries even with minor pain. Following symptoms develop with the passage of time should be remembered.
- Mild or severe swelling.
- Knee pain.
- Trouble while walking or putting some weight on knees.
- Wobbly sensation in your knees.
If left untreated, the Posterior Cruciate Ligament Injury may develop Osteoarthritis in your knees over time.
Diagnosing Posterior Cruciate Ligament Injuries:
In most situations, the doctors take the following steps to diagnose the PCL injuries.
The doctor will definitely like to learn about the patient’s history of movements or physical activities. For example, the doctor will ask the type of activity while you get PCL injuries such as playing a game, driving a car or anything else. The doctors may also ask following questions.
- Was your knee twisted, straight or bent when PCL injury happened?• What was the feeling after the knee injury?
- What were the injury symptoms you observed?
This is a common and simple method. The doctor will ask you to lie on back and bent the knees. In this position, the doctor will check the knee situation and press the upper shin. He will diagnose a PCL injury if the knee moves abnormally during this test.
A doctor may also use arthrometer which is a simple device. This device is used to determine the tightness of ligaments by pressing against the leg. In some cases, the doctor diagnoses the PCL injury by seeing your walking movement. Abnormal walking movement is a clear indication of Posterior Cruciate Ligament Injury.
This is a modern medical technology in which X-Rays are used to take more details about Posterior Cruciate Ligament Injuries. These are highly used to see the nature of the damage, pieces of bones and tears in the ligaments causing the injuries.
Magnetic Resonance Imaging (MRI):
This is another general approach to find clear images of the damaged ligaments. MRI is used for precise identification of the location of damage or injury. A bone scan is also a common method to see the nature of damage to the bone because of the Posterior Cruciate Ligament Injuries.
Home Treatments of PCL Injuries:
For mild Posterior Cruciate Ligament Injuries, simple techniques can work. The doctors may recommend P.R.I.C.E. approach to heal the injury at home. This includes the following steps:
- Protecting: You have to protect your knees from injuries.
- Resting: Keep your knees in resting positing to allow speedy healing.
- Icing: This is an old but efficient technique of applying ice to the injured areas. Applying the ice or modern Coldest Ice Packs on the injured knees for short duration may lessen the pain and swelling.
- Compressing: This keeps the knee immobile. You can compress the knee with an elastic bandage. However, use the compression gently.
- Elevating: Keep the injured knee elevated by putting a cushion of a pillow under it.
You may also require pain-to relieve medication to control knee pain. Always use NSAIDs (Non-steroidal Anti-inflammatory drugs) to avoid further issues.
Nonsurgical Treatments of PCL Injury:
It is easy to heal the Posterior Cruciate Ligament Injury using a nonsurgical method. There is no need to think about surgery if the damage is mild. Following PCL injuries usually don’t need surgical operations.
- Grade 1 or 2 acute PCL injuries especially if other ligaments are safe.
- Recently identified chronic PCL injury that has no symptoms especially if it doesn’t damage other ligaments.
In some cases, the patients may require physical therapy to heal the PCL injury. This is a rehabilitation approach which is mostly used before or after surgical operations. This approach may include the following steps:
- Utilizing crutches initially, then gradually putting more weight while walking.
- Getting the assistance of a machine or a therapist to move the knee gently in order to achieve the natural range of motion.
- Using a knee brace to get temporary support.
- Strengthening the muscles of thighs in order to deliver more support to the knees while they get stable.
- Workout (walking or running) inside a pool or with a treadmill for a limited time period (10 to 15 minutes) a couple of events in a day.
- Receiving specialized training to resume sports activities. This is essential if you want to resume your previous activities. Never try to play sports until your doctor gives permission for it. Proceeding without medical attention may lead to further damage to Posterior Cruciate Ligament.
Treating the Posterior Cruciate Ligament Injuries with Surgery:
In some situations, surgeries become important to treat the Posterior Cruciate Ligament Injuries. These situations include the following.
- If the knee or other bones are loose or have torn off in different Posterior Cruciate Ligament Injuries.
- If more than one ligament of the knee or associated bones damaged.
- Chronic Posterior Cruciate Ligament Injuries causing loosening with several symptoms especially in sportsmen or athletes.
The bone surgeons fasten the bone by using a screw if it tore off. This type of surgery recommended if one or several bone pieces identified after the MRI test. However, the surgeons may recommend complete replacement of a ligament if it was totally damaged. It is easy to identify the exact location of Posterior Cruciate Ligament Injuries when the surgeons use MRI. They identify the damage location, bone pieces, tissue ruptures and any other condition which requires partial or complete replacement. In some cases, surgeons recommend stretching the damaged ligaments. This technique is effective to manage to loose ligaments. Stretching the torn ligaments won’t work in most cases.
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Ligaments usually replaced with:
• Ligament tissues obtained from a deceased donor. A precise technique used to match the ligament tissues. It is important to see the healthy condition of tissue before obtained. Proper hygiene is also an essential matter in this matter.
• A small piece of tendon cut from other parts of the body. The surgeon obtains this piece from the back of the heel or thighs. The doctor replaces this piece with the damaged one by using a small incision in the knee.
Usually, surgeons use “Open Surgery” for these types of operations. This needs a large incision with a surgical instrument in the knee. An arthroscope is a surgical tool that used for less-invasive surgeries. This tool is mostly used when surgeons require a small incision in knees. The duration required of rehabilitation after knee surgery depends on the type of damage. However, it takes 26 to 53 weeks in most cases.
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