The PCL, a thick major ligament in the knee, is located behind the ACL, and prevents the shin bone (tibia) from moving backwards against the hip bone (femur), as opposed to the Anterior Cruciate Ligament which prevents the forward movement of the tibia. The ACL and PCL are both responsible for the proper positioning of the bones which together make up the knee joint.
Torn Posterior Cruciate Ligament (PCL)
The PCL will be typically torn as a result of trauma to the front of the knee or to the upper hip, while the knee is bent, such as during a car accident, when the knee might be struck by the car’s instrument panel, or otherwise in a motorcycle accident, or any other accident, which involves falling on the knee.
These injuries, resulting in a torn PCL , are far less common than ACL injuries. In most cases, the PCL rehabilitates spontaneously to a certain degree, which is why most patients return to their active life after receiving some conservative treatment, and without the need for a PCL reconstructive surgery.
However, in some cases, a significant instability remains in the knee, mostly in cases where the PCL is injured along with other knee ligaments, leaving the injured individual with a significantly unstable knee. In those cases of a significantly unstable knee, Dr. Suzanna Horovitz recommends Arthroscopic Reconstructive PCL Surgery, performed through small incisions, and without opening the knee joint.
PCL Reconstructive Surgery
Instead of the torn ligament, an implant is used, typically an implant from an organ bank called allograft.
The implant undergoes preparation for transplant, immediately followed by knee arthroscopy, accompanied by repair of any damage caused to the meniscus or cartilage. using special devices, small channels are drilled into the bones of the knee, through which the implant is inserted, in a location which mimics the correct anatomical positioning, prior to injury, of the ligament being replaced. After inserting the implant through the drilled channels, it is fixed on both ends by screws or pins. Normally, this implant will never need to be removed.
Post surgery treatment
After surgery, the patient will remain hospitalized overnight, with a cooling bag keeping the patient’s knee cold.
Due to advancements in surgical technique and medical equipment available today, Dr. Suzanna Horovitz believes in a rehabilitation process which allows patients to return to their active life. Accordingly, as early as the first day after surgery, the patient will begin physiotherapy with a certified physiotherapist, in order to achieve maximum results for the knees, according to an established rehabilitation protocol, with the goal of enabling the rehabilitation of the knee’s stability, and without injuring the reconstructive implant. In the same day the patient will begin walking with crutches and as much weight bearing, as possible.
Except for performing rehabilitative activities, the knee is fixed in a splint during the first six weeks after surgery, in order to allow the patient to maintain their ability to fully extend their knee as early as the beginning of rehabilitation.
The small scars which are left after the surgery will be sealed with surgical pins for two weeks, and then removed by the doctor or by a nurse.
To prevent infection, the patient will be treated with antibiotics once before surgery. In order to keep the small wounds clean, the patient should remove the bandages as early as two days after surgery, and wash with water and soap. Baths are allowed only after two weeks have passed since surgery.
If you suffer from an Orthopedic problem in your knee, Dr. Suzanna Horovitz may be able to assist you to return to an active life. For consultation and diagnosis, press here.