What happens if I injure my Posterior Cruciate Ligament?

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What is a Posterior Cruciate Ligament injury?

The posterior cruciate ligament (PCL) is located at the back of the knee. The PCL connects the thighbone to the shinbone. Ligaments are strong bands of tissue that attach bones to one another. A PCL injury is not usually as serious as an ACL injury, though it can still cause pain and a feeling of weakness in the knee.

How does a PCL injury usually occur?

A PCL injury usually happens when a force is directed towards the back of the knee from the front of the shin bone close to the knee. Examples of such injuries include landing on your shin bone after a fall, with your knee in a bent position.

You may hear a painful popping sound and may have difficulty straightening the knee or walking after the injury.

What are the symptoms of a PCL injury?

Although the signs and symptoms of a posterior cruciate ligament injury may be mild for certain individuals, over time, the symptoms may worsen. These signs and symptoms include:

  • mild to moderate pain which may start at the back of the knee.
  • over time the patient may experience pain at the front of the knee which may get progressively worse
  • stiffness
  • difficulty walking
  • instability (your knee might give way) especially when climbing stairs
  • swelling may occur at the back of the knee, but is usually missed

Isolated PCL injuries typically do not cause a lot of problems. With a good rehabilitation program, most patients do not require surgery.

Occasionally, however, the PCL injury may be part of a larger injury involving other ligaments that help to stabilise the back and outer side of the knee joint. In that case, the knee is usually very unstable, and surgery is usually required.

PCL injuries that are left undiagnosed may give rise to damage to the cartilage over the knee cap bone, if this is severe, the patient may require subsequent surgery or may even develop knee arthritis in the future.

Assessment and Work-up

A posterior cruciate ligament injury is usually diagnosed with a combination of history and physical examination, as well as an MRI scan.

During the physical exam, the doctor may press on your knee to feel for any looseness, injury, or fluid in the joint from bleeding. The doctor may also move your knee or leg in different directions and instruct you to stand or walk. Your knee would be compared with a healthy one to look for any injury.

The MRI scan is an important tool to assess knee injuries such as the PCL injury as it allows the doctor to check the status of the ligaments in the knee without the need for radiation or surgery. In addition, the MRI scan will allow the assessment of other injuries within the knee joint.

What are the Treatment Options?

Treatment options vary for each individual depending on the extent of their injury. There are both non-surgical and surgical options. However, surgery is often not required unless it is associated with other ligament injuries.


Therapy is a common option to enable one’s knee function to improve over time. It also helps to strengthen your knee. This is conducted by a physiotherapist who will teach you exercises to practice.


If the PCL injury is severe or if it is combined with other knee ligament injuries, cartilage damage or broken bone, surgery may be needed. If you have persistent knee instability despite physical therapy, surgery would also be considered an option.

This surgery can be performed arthroscopically through several small incisions around the knee. A camera would then be inserted into the incision sites for the surgeon to perform the surgery. After surgery, you may have to wear a knee brace, use crutches as well as undergo a course of physical therapy.

Rehabilitation and Recovery

Rehabilitation of a PCL injury depends on whether surgery was performed or not. In the case of a PCL injury managed without surgery, the patient typically undergoes 6 to 12 weeks of knee rehabilitation and is usually able to return to sport thereafter.

Rehabilitation following surgery for PCL injury will depend on the type of surgery performed, and the other injuries that occurred together with the PCL injury. Depending on the severity, such rehabilitation can take up to a year before the patient is able to return to sport.

For assessment of your condition, please book an appointment with Dr Yong Ren.

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Sarah Taylor

Obstetrics & Gynaecology