Injuries and Conditions: Knee: Posterior Cruciate Ligament Tear: Medical Details
Overview Ligaments play a critical role throughout the body by providing
an additional support structure for the joint and to allow for the stable movement of the joint.
The PCL is one of the four major ligaments in the knee connecting the bones of the upper and lower leg. The primary purpose of this ligament is to provide stability and to limit excessive backward motion of the lower leg. During vigorous activities like running, turning, or jumping that
place a considerable load on the joint, the PCL helps stabilize and control excessive movement of the knee. Due to the PCL's location and size, the ligament is not usually injured except during high energy impacts or stresses.
Causes of Injury
A PCL injury is typically the result of a direct blow to the knee while the knee is bent and the foot planted.
Injuries may occur during contact sports like football, during tackles, and in other activities where sudden
changes in direction result in excessive rotation of the upper leg against the lower leg.
The severity of the injury can vary greatly according to the stress placed on the joint. An especially forceful blow or twisting motion may completely tear the PCL.
Activities like skiing, where the lower leg is fixed to the ski while the upper leg is mobile and able to rotate, can place extreme stress on the knee joint.
PCL injuries are also common in other activities like basketball, soccer, and football that involve running, sudden turning and stopping.
Hyperextension or over-straightening of the leg, forceful cutting, pivoting, or sudden stopping can result in injury. The potential for injury increases significantly if forceful contact (e.g. tackling in football or soccer) occurs when the knee is in any of these positions or movements.
Diagnosis
The initial diagnosis of the injured knee may be made difficult because of significant pain, swelling in the joint, and spasm of the muscles surrounding the joint. However, a gentle physical examination is usually sufficient to provide a diagnosis. More serious PCL injuries may require a delay in the examination of the injured joint to allow for the initial swelling and muscle spasms to decrease. The delay will allow the patient to tolerate the movement of the knee necessary for a more thorough evaluation.
Less severe injuries will typically not demonstrate this excessive movement, but patients will complain of pain and demonstrate the swelling similar to that of a completely torn PCL. It is possible for some patients to significantly injure their PCL, but complain of only minor symptoms; only upon a second or re-injury of their PCL, do some patients seek medical attention.
Symptoms
Considerable pain in the knee that does not go away within the first few hours after the injury.
Immediate (usually within 24 hours) swelling of the knee.
A feeling of unsteadiness and a tendency for the knee to "give
way," or even a complete inability to bear weight on the injured leg.
An audible "pop" or the perception of something snapping or breaking at the moment of injury.
A feeling of "fullness or tightness" in the knee.
Anatomy
Product Considerations
Knee: Ligament Brace Functional braces are designed to control abnormal motion of an unstable knee. Because ligaments help stabilize the knee, and a torn ligament leads to instability, these braces are also called Ligament Braces. The intent is to allow a previously injured athlete to compete at a higher level than they would otherwise be able to without the brace. The brace is designed to support either a newly reconstructed ligament such as the ACL, or a weakened or injured ligament, which is being treated in a conservative manner. The role of a functional brace is to increase stability to a previously injured knee.
Type of Injuries:
Pre-operative ACL/PCL ruptures/injuries
Non-surgical ACL/PCL injuries
General knee instability
Pre/post joint replacement with ligament instability.
NSAIDs NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
Pain resulting from inflammation or swelling.
Pain after injury.
Joint pain and arthritis.
Knee: Cold Therapy Cold therapy is used to reduce pain and swelling and is a convenient method to apply cold to an injured or rehabilitating extremity, such as a knee or shoulder. A cuff fits like a sleeve around the extremity and utilizes cold water supplied by a connected thermos or canister to chill the extremity. Water flow into the cuff can be controlled by different mechanisms. The simplest way is gravity; elevating the canister fills the cuff and controls the amount of pressure against the extremity. Water flow may also be controlled by a pump which will automatically circulate the cold water to and from the cuff. After surgery or immediately following an injury, the canister should be refilled with cold water every one to two hours to maintain a proper temperature. The cold therapy may also be used during rehabilitation, especially after physical activity, reducing the inflammatory heat from exercise.
Cold therapy can be used to treat:
Knee, Shoulder, Elbow, Wrist and Hand, Back, Hip, and Foot & Ankle Injuries.
