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Posterior Cruciate Ligament (PCL) Reconstruction

at Cedars-Sinai Marina del Rey Hospital

Since 1969, our hospital has been providing healthcare at the highest standards, and our orthopaedic surgeons have the required experience and knowledge to offer you the surgical treatment you need for your posterior cruciate ligament tear. Before deciding on the best and safest surgical approach, you will be thoroughly evaluated by our skilled and well-trained medical team so as to determine with certainty which procedure is right for you.

If you choose to undergo surgery for a posterior cruciate ligament tear at Cedars-Sinai Marina del Rey Hospital, you will benefit from the treatment your injury requires in a calm and warm environment. We place tremendous emphasis on the comfort of our patients and have always been striving to deliver the best results and to eliminate the cause of the suffering of our patients by using the latest medical technology.

This surgery concerns the knee, namely the repair of a torn posterior cruciate ligament in the knee. Posterior cruciate ligament tears usually occur as a result of trauma, such as car accidents or falling on the knee when bent. They are also common in people who play sports on a regular basis. Because posterior cruciate ligament tears involve a lot of pain, they generally require surgery. The posterior cruciate ligament has the role of connecting the back of the thighbone to the front of the shinbone, and it runs diagonally in the middle of the knee.

There are 3 grades of injury to the posterior cruciate ligament, namely:

  • grade I – the ligament is mildly damaged and slightly stretched, while the knee joint is stable
  • grade II – it entails the partial tear of the ligament
  • grade III – the ligament is completely torn, divided into two halves, and the knee joint is unstable

Consequently, how complex the reconstruction surgery will be will highly depends on the extent of the damage of the posterior cruciate ligament. It is worthy of note that injuries to this ligament are quite rare and also challenging to detect in comparison to other knee ligament injuries. Another important aspect you should keep in mind is that not all injuries to the posterior cruciate ligament require surgery. However, the only person who can tell you for sure whether you need to undergo surgery for your ligament tear is a surgeon who specializes in orthopaedics.

Most procedures aiming to repair a posterior cruciate ligament tear are performed by using knee arthroscopy, which is minimally invasive. During the surgery, several tiny incisions will be made around the knee joint, and a narrow fiber-optic scope is inserted through one of the incisions, which allows the surgeon to assess the damage. Subsequently, the medical instruments are inserted through the incisions in order to repair the tear in the posterior cruciate ligament. This is achieved by removing the affected ligament and replacing it with a graft. 

Tunnels will be drilled into your thighbone and shinbone to allow the surgeon to precisely position the graft, which will be attached with screws or other fixation devices. The graft will be collected from another part of your body, and this procedure will not affect the function of that part of the body in any way. This approach is known as autograft and is also the most successful, as people who have their posterior cruciate ligament tear repaired with tissue from their own bodies will be able to resume their usual activities, including sports, within a shorter period of time.

There are numerous benefits of undergoing posterior cruciate ligament reconstruction, some of the most important being improved knee stability and function, as well as the prevention of additional damage to the ligament in the future. When they also do physical therapy, the patient will eventually have a nearly normal knee once again, and they will also be able to return to work and resume their hobbies within a shorter period of time. Other notable benefits of posterior cruciate ligament reconstruction include:

  • your knee will not give way anymore
  • you will be able to be more physically active
  • you will be able to play sports that require a lot of pressure on the knee
  • you will no longer experience pain in the knee area
  • your knee will no longer feel stiff
  • you will no longer have difficulty bearing weight
  • your knee will be stable
  • you will no longer have numbness or tingling in your knee

Recovery

Following surgery, you will have to maintain your knee in full extension, and it will be supported by a brace for 2 to 4 weeks, depending on the complexity of the injury you had. You should refrain from bearing any weight on the knee in question during the recovery period. To be more comfortable, you can place a pillow or another support under your shinbone for the first 2 months after the posterior cruciate ligament reconstruction so as to prevent any posterior damage to that bone.

It will be only after 8 weeks of rest that you can begin rehabilitation, during which you will be allowed and encouraged to start bearing weight on your knee. Lastly, until your ligament is fully healed, you may be recommended to use crutches when moving around to promote a complication-free recovery.

Risks

The most frequently associated risks with posterior cruciate ligament reconstruction are residual knee instability and knee stiffness. Furthermore, the patient may experience the following after the surgery:

  • infection
  • numbness
  • damage to the nerves or blood vessels
  • blood clots
  • failure of the graft
  • decreased range of motion
  • loosening of the graft

In rare cases, people who underwent posterior cruciate ligament reconstruction will continue having instability in the knee joint, pain in the knee that will cause limping, and difficulty walking. Nevertheless, if all the particularities of your injury are taken into consideration before the surgery, the chances of experiencing these problems are very low.

Complications

The rate of complications when it comes to posterior cruciate ligament reconstruction is very low, especially if the orthopaedic surgeon has vast experience and has thoroughly studied the nature of the patient’s injury before performing the procedure. Unfortunately, complications such as the following may still occur in some cases:

  • neurovascular injury
  • the death of bone tissue due to lack of blood supply
  • shinbone fracture
  • loss of motion in the knee
  • persistent laxity

If you choose our hospital to undergo posterior cruciate ligament reconstruction, you can rest assured that our medical team, as well as your orthopaedic surgeon, will pay attention to all the aspects involved in your ligament injury before performing the surgery. This way, your risk of experiencing unpleasant or serious complications will be very low.