Na zdjęciu uszkodzenie więzadła krzyżowego tylnego (PCL)
POSTERIOR CRUCIATE LIGAMENT (PCL) INJURY
Damage to the posterior cruciate ligament (PCL) is less common than anterior cruciate ligament (ACL) injury, but it is a serious knee joint injury. It most commonly occurs as a result of sports injuries, with the highest frequency in sports such as volleyball, basketball, soccer, or rugby. PCL injuries are often seen in patients complaining of knee pain after car accidents.
The most common mechanisms of PCL injury include a direct blow to the lower leg from the front, such as hitting the shin against the dashboard in a bent knee position during a frontal car collision. Another mechanism of injury is a dynamic hyperextension of the knee, such as landing on a fully extended leg.
Symptoms of PCL injury may include:
- Pain in the posterior region of the knee joint
- Swelling in the knee joint
- Joint instability
- Difficulty in knee flexion
- Difficulty in walking on stairs or uneven terrain
Diagnosis after a PCL injury involves a thorough physical examination, including an assessment of the range of motion and stability of the joint. A positive “posterior drawer” test is characteristic. Imaging modalities such as X-rays and magnetic resonance imaging (MRI) are also performed to evaluate the extent of ligament damage. Sometimes, stress X-rays (TELOS) are necessary to visualize ligament insufficiency.
In the initial phase after the injury, conservative treatment is recommended. This includes rest, immobilization of the knee joint with a brace, ice application, as well as pain medication and thromboprophylaxis. The patient avoids weight-bearing and may require the use of crutches for ambulation.
The posterior cruciate ligament has a greater potential for healing compared to the anterior cruciate ligament due to its biomechanics and, most importantly, its better blood supply. This allows for non-operative treatment options.
In cases of PCL injuries, non-operative treatment may involve initial immobilization followed by intensive physiotherapy to reduce swelling, strengthen the muscles around the knee joint, and ultimately improve stability.
In cases of complete posterior cruciate ligament (PCL) injury with joint instability, surgical treatment may be necessary. The surgery may involve reconstructing the ligament using a graft, often taken from the patient themselves. Graft options can include tendons from the hamstring muscles. After the surgery, the patient will need to undergo a prolonged rehabilitation process to restore full functionality of the knee joint.
In every case of PCL injury, it is important to consult with an orthopedic surgeon who can accurately assess the extent of the damage and stability of the joint based on physical examination and imaging studies. They can then recommend the appropriate therapeutic approach.
At MIRAI, the following individual specializes in the knee area:
Tomasz Szymański – material development for the website
Feel free to visit us!