Posterior Cruciate Ligament Injury: The Forgotten Knee Ligament

The Posterior Cruciate Ligament: The ACL’s Little Known Brother

Posterior cruciate ligament injury (PCL) are far less common than ACL injuries. Studies show they occur at a ratio of around 10:1. The reason for this difference lies not in ligament strength but in the type of force involved. The mechanism that causes a PCL tear is quite different from the force that damages the ACL. These forces are less common, which is why PCL injuries happen less often.

The Mechanism of a PCL Injury Is Typically the Result of Either:

• A direct impact to the top of the shin bone (tibia). This can happen during a car accident—such as when the shin strikes the dashboard—or in contact sports like football during a hard landing or tackle.
• Forced deep bending of the knee while under load. This might occur when landing poorly from a ski jump or falling onto a bent knee during sport.

Other Injuries Often Accompany Posterior Cruciate Ligament Injury

PCL injuries often occur alongside other knee ligament injuries. That’s why a full ligament assessment is essential. Even when isolated, most PCL injuries—regardless of severity—are treated without surgery. In fact, many athletes return to their pre-injury performance levels with time and proper rehabilitation.

Non-Surgical Management of PCL Injury

Most PCL tears respond well to conservative treatment. Management typically involves physiotherapy along with a tailored gym and sport-specific rehab program. Athletes often begin a gradual return to training within 6 to 12 weeks post-injury. This return may or may not include the use of a supportive knee brace.

Some athletes choose to wear a brace during their return to sport, especially if they feel ongoing instability. In cases where the PCL remains deficient, bracing can provide extra support and confidence during the transition back to play.

Surgical Management of Posterior Cruciate Ligament Injury

Surgery is usually considered when a PCL tear occurs with other significant ligament damage. Occasionally, athletes with isolated but complete PCL ruptures may also need surgical reconstruction. This is typically due to ongoing instability or persistent pain that affects daily life or performance.

While ACL reconstruction has well-established success rates, PCL surgeries are more unpredictable. Recovery and outcomes can vary more, making surgical decisions less straightforward for PCL injuries.

Long-Term Consequences Associated with a PCL Injury

A PCL injury can impact the knee long term—especially if combined with other joint trauma. Altered joint mechanics from a torn or absent PCL can lead to premature knee osteoarthritis. This risk highlights the importance of early diagnosis, guided rehab, and long-term monitoring after injury.

Disclaimer: This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical advice or assistance on Posterior Cruciate Ligament Injury: The Forgotten Knee Ligament should consult his or her general practitioner, physiotherapist, orthopaedic surgeon, or another qualified practitioner.