The PCL (Posterior Cruciate Ligament) lies at the back of the knee and is an important contributor to knee stability. It is most commonly injured when the knee is 'hyperextended' or bent too far forwards, but can be injured in many other ways. It is a particularly common rugby injury resulting from a head on tackle, and is often seen in 'dashboard' injuries in car accidents.
At the time of significant injury there is pain felt deep in the knee or at the back of the knee. There may be a snap, pop, or tear. The knee will swell gradually, and may feel unstable. The initial injury may not appear as severe as an ACL injury. The knee will settle over a period of weeks, but will never feel quite right afterwards.
If you think you have this injury it is important to get it checked out by Mr Willis-Owen. It is best to stop sports to prevent further damage. It is important to treat the early phase with rest, ice, compression and elevation in order to minimise the bleeding and swelling. You should avoid any activities that lead to giving way, because each time this happens there can be further damage to the knee.
Treatment involves first confirming the diagnosis and establishing whether any other structures are damaged. This usually means a careful examination and an MRI scan. Often there can be meniscal tears in association with a PCL rupture. Despite a lot of research we still do not know the best way to treat PCL injuries. Mild PCL injuries often do not need surgery and will get better with intensive rehabilitation. More severe PCL injuries, or when a number of structures are injured, do best with reconstruction. These injuries are quite uncommon so it is important to see someone genuinely experienced in treating them such as Mr Willis-Owen.