PCL Arthroscopy

The Posterior Cruciate Ligament (PCL) is the thickest of the ligaments stabilizing the knee; although it is twice as strong as the Anterior Cruciate Ligament (ACL), it is less well known to the lay public because it is much less frequently injured, and hence, a smaller percentage of reputed athletes attract media publicity with tears of this ligament. Knee arthroscopy has been a great asset to the diagnosis and treatment of torn knee ligaments. Arthroscopically assisted surgery to reconstruct the (ACL) has become an international standard. Many successful techniques presently in use were developed by members of the Arthroscopy Association of North America (AANA), which organization offers workshops to teach arthroscopic surgery to orthopedic surgeons. Such workshops are also available to teach arthroscopically assisted reconstructive techniques for the ruptured PCL. Whereas, results of reconstructions for the PCL were relatively inferior to those for the ACL in past years, progress with PCL repair and reconstruction techniques has led to improved surgical outcomes, due in large measure to improvements in arthroscopically aided reconstruction. Authoritative articles regarding arthroscopic surgery for tendons, ligaments, and joints of the musculoskeletal system are to be found in the Journal of Arthroscopy: The Journal of Arthroscopic and Related Surgery, the official publication of AANA and the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine [ISAKOS]- www.arthroscopyjournal.org.

The PCL, in conjunction with the other ligaments of the knee, helps to stabilize the knee and to prevent it from giving way; furthermore, and just as importantly, the combined knee ligaments insure that the articulating surfaces of the shin and thigh bone (tibia and femur, respectively), where they meet to form the knee joint,  glide upon one another on an optimum track during flexion, extension, and rotation of the knee. Whereas lesser isolated injuries of the PCL can usually be managed non-operatively, major PCL ruptures and those combined with injuries to other ligaments and cartilages, are best managed by surgical repair and reconstruction to avoid excessive instability and subsequent osteoarthritis.  

The PCL is most frequently injured as a result of motor vehicles accidents, whereby, the shin bone impacts the dashboard with the knee flexed, driving the shin backward. Both hyperflexion and hyperextension injuries of the knee can tear the PCL. Evaluation to quantify damage is accomplished by assessing the mechanism of injury, physical examination, arthrometers that measure ligament deficiency, x-ray, MRI, and arthroscopy