Posterior Collateral Ligament (PCL) Tear/Sprain
Definition:
Primary restraint to posterior translation & medial rotation with ACL. Damage usually only occurs with significant trauma (motor vehicle accident or landing in a hyper flexed knee position from a jump) (Dutton).
Subjective:
Objective:
Intervention:
Primary restraint to posterior translation & medial rotation with ACL. Damage usually only occurs with significant trauma (motor vehicle accident or landing in a hyper flexed knee position from a jump) (Dutton).
- Categorized as Grade I, II, or III ranging from slightly stretched, mild damage to partial tear to complete tear (AAOS).
Subjective:
- Pain in posterior aspect of knee
- Pain aggravated with kneeling
- Instability may or may not be present (Dutton)
- Stiffness and difficulty walking are also noticeable symptoms (AAOS).
Objective:
- Posterior Drawer test - knees bent at 90 degrees the tibia is pushed posteriorly, if there is greater than 5 millimeters of translation it is a positive test (UCSF).
- Other diagnostic tests include radiographs, MRI and arthroscopy (UCSF).
Intervention:
- Conservative treatment is adequate for an isolated tear because there is usually not functional instability (Dutton).
- Acutely, use RICE (rest, ice, compression, and elevation) to decrease inflammation and promote the healing process (AAOS).
- Focus on restoring range of motion and strengthening the quadriceps
- Important to delay hamstring strengthening for 6-8 weeks following injury in order to decrease stress on PCL (Dutton).
- Use open and closed kinetic chain exercises to improve stability (Dutton).
- Recovery depends on severity of injury (AAOS).
- Surgical intervention may be necessary if other structures are involved (UCSF).
References:
- Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
- AAOS. Posterior Cruciate Ligament Injuries. American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine. Accessed 23 June 2012 http://orthoinfo.aaos.org/topic.cfm?topic=a00420
- UCSF. Orthopedics, PCL Tear Diagnosis. University of California San Francisco. Accessed 26 June 2012 http://www.ucsfhealth.org/conditions/pcl_tear/diagnosis.html
- Image: http://www.examples10.com/e/ligaments/