PCL Rupture

01.04.2020

SYMPTOMS

You have injured your knee, the posterior cruciate ligament (PCL) has been torn. You like to be active in sports, possibly in knee weight-bearing sports such as soccer, handball, or skiing, or you practice a physically demanding job. A PCL injury can initially appear relatively harmless, as the knee can quickly calm down.

The uncomfortable aspect of the PCL injury is that anterior knee pain can develop in the area of the kneecap in the long term, which depending on    the situation may no longer disappear, even after stabilization.

EXAMINATION

Usually, there is nothing especially noticeable about your knee. However, specific tests can show a clear difference between the injured and the uninjured knee. The injured knee has too much play. This laxity, towards the back of the knee in PCL injuries, can be measured in millimeters.

TREATMENT

Most of the time we recommend specified physiotherapy so that you have developed your muscles as well as possible before the operation and you already know what to expect afterwards. A special knee support with a spring mechanism helps you to align your knee well in advance of the operation. This brace is an important aid   before   but   especially   after the operation.

LEGEND

Arthroscopic View Right Knee
1 – Subtotal ruptured posterior cruciate ligament (PCL)
2 – X-ray guided control during the operation
3 – Reconstructed PCL

SURGICAL PROCEDURE

We prefer to use a strip of your quadriceps tendon as a PCL graft. We have had very good experience with this, and the tendon removal causes almost no discomfort. Using arthroscopy (keyhole surgery) we assess the PCL damage and all other relevant structures in your knee. Whenever possible, accompanying injuries, such as damage to the meniscus or cartilage, are treated immediately. At an anatomical location, we drill an arthroscopically controlled short, non-continuous bone socket to secure the bone anchor, then a tunnel in the thigh in order to be able to tighten and anchor the new ligament instead of the torn one. Duration: about 2 to 2.5 hours.

RISKS

You will be treated by our experienced surgeons. And yet it is like flying: no surgery is without risk. The risks of this operation can be summarized as follows:

  • Risk of infection: ~ 1%
  • Probability that you will require a blood transfusion: less than 1%
  • Damage to relevant blood vessels: ~ 2%
  • Damage to relevant nerves: ~ 2%
  • Thrombosis/Embolism: ~ 2%
  • Relevant residual instability: ~ 10%

HOSPITAL STAY

After the operation, your leg is positioned in an immovable padded fabric splint, as we do not want the knee to be agitated at the beginning and want to counteract the force of gravity that wants to pull the lower leg towards the back. As soon as you can get up quite easily and the swelling allows, we will remove this splint and use the spring brace again. As soon as you are feeling well again, you will be discharged. This is usually the case on the 4th – 5th day.

DISCHARGE

The stitches can be removed by your family doctor about 12 – 14 days after the operation. We will see you routinely after 6 weeks (with an X-ray image), and 3 and 6 months for check-up visits in our outpatient clinic. Usually you should, be feeling fine after 6 months, at which point we can complete the treatment.

DISCHARGE

The stitches can be removed by your family doctor about 12 – 14 days after the operation. We will see you routinely after 6 weeks (with an X-ray image), and 3 and 6 months for check-up visits in our outpatient clinic. Usually you should, be feeling fine after 6 months, at which point we can complete the treatment.

WEIGHT-BEARING, WHAT CAN I DO and WHEN?

Crutches, partial weight-bearing: 6 Weeks
Spring brace, day and night: 3 Months
Sports after: 3 – 4 Months
Soccer and Skiing: 12 Months

 

 

 

 

pdf for download: 4 PCL reconstruction English

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