Trauma to the posterior cruciate ligament of the knee. Treatment of a torn posterior cruciate ligament Ruptured cruciate ligament of the knee

Consider the causes and symptoms of ruptures for each type. The anterior ligament is damaged ten times more often, so we will pay more attention to this injury.

In medical circles, this ligament is abbreviated ACL and is the most injured part of the knee. Usually, ligament tears are associated with sports and often occur due to the curvature of the lower leg. Diagnosis can be carried out by several methods, but the most effective of them is MRI.

The main function of the ACL is to keep the lower leg from shifting inward and forward. From this, the mechanism of injury in which a rupture occurs is also clear - often these are rotational movements on one limb, when the foot does not move, and the thigh with the body scrolls outward. Although it is worth noting that in reality both the mechanisms and the causes of gaps are much more complicated.

What Causes ACL Ruptures?

Ligament injury - scheme

The ligament can be damaged due to direct injury (with a contact effect on the joint) and indirect (with a non-contact effect - for example, when rotating on the leg, followed by sudden braking).

The most common mechanism is considered to be external deviation of the lower leg and twisting of the thigh inward. Quite often this happens in football, hockey and other sports where you need to turn around sharply or land after a jump and then turn your body. By the way, under such circumstances, a meniscus rupture also occurs.

Note! Understanding the mechanisms is essential for the detection and prevention of ACL ruptures. The correct diagnosis is made only on the condition that the victim describes in detail the moment of injury. For this reason, knowledge is necessary for both doctors and people involved in sports.

If the athlete understands the mechanisms of injury, he will be able to avoid situations that lead to ACL rupture. It is also worth noting that the indirect effect prevails among other mechanisms and implies that the knee joint was not subjected to external loads. If there were such loads, then we are talking about a contact mechanism (often a blow to the thigh or directly to the knee).

Symptoms of injury

The main sign of ACL rupture is obvious joint instability. And if you ignore it for a long time, it can cause early arthritis. In the case of pronounced instability, an operation is required to reconstruct the ligament (performed in one of several ways). Then, after six months, a person will restore his former physical activity.

As noted above, the gap occurs due to injury, after which there are sharp pains and swelling in the knee. Cracking is often heard, although this symptom can also be observed when other ligaments are torn. Another person can feel the “dislocation” of the lower leg to the side and forward. If you have one of the symptoms, you should immediately seek medical help.

When the ACL ruptures, blood can enter the joint - this phenomenon is called hemarthrosis. During the first few days, the severity of pain and hemarthrosis can be so strong that the doctor simply cannot examine the knee with his hands (this is what allows you to make an accurate diagnosis).

Diagnostics

First, the doctor must determine the mechanism of injury, and then proceed to examine the joints. The intact knee is examined first (so the patient will be able to familiarize himself with the examination procedure, moreover, in the future there will be something to compare the results with). If testing is done carefully, then no additional research methods will be required to diagnose ACL rupture. But due to the need to exclude other injuries (for example, rupture of other ligaments or meniscus), MRI, ultrasound, X-ray examination can be used.

The location of the cruciate ligament rupture from the surface of the tibia is shown.

Posterior cruciate ligament

It is located directly behind the front, and a powerful impact is required to damage it. Often, the rupture of the ZKS is the result of a blow to the lower leg (it can happen during sports or an accident). For example, if a low car hit the bumper under the knee joint. This can happen to drivers too - in an accident, a person shifts forward and hits his knee on the dashboard.

Note! To avoid this kind of injury, modern car models are equipped with additional airbags located under the dashboard.
The only effective way to avoid a break is to restrict activity. You can also strengthen the muscles of the joint, but this does not always help.

Diagnosis is carried out in the same way as with a rupture of the ACL, but the doctor must take into account that such an injury occurs only with very strong blows. Therefore, an x-ray is necessarily performed - they are looking for fractures on it. A clear sign that the PCL is damaged is a slight subluxation of the knees backwards - this is clearly seen in the picture in the lateral projection.

How is it treated

Rupture of the cruciate ligaments of the knee can be treated conservatively and surgically. Let's take a look at the features of each option.

conservative methods

Immediately after the injury, swelling and pain are removed, after which the former mobility of the joint is restored. Conservative methods include cold compresses, anti-inflammatories and, of course, rest. In addition, the patient may be prescribed special exercises and physiotherapy.

With regard to exercise, they are aimed at restoring mobility and preventing muscle atrophy. It is also recommended to wear special knee pads, which can be of several types.

Note! Calipers are not always able to fully protect the knee joint, moreover, when playing sports, they can give a false sense of reliability.

For this reason, people involved in sports are advised to perform operations, and calipers are prescribed at least six months later.

Surgery

In case of ineffectiveness of conservative methods, surgical treatment is performed. Even if it is immediately clear that an operation is indispensable, patients are still prescribed physiotherapy and gymnastics to relieve swelling and restore mobility.

As a rule, in case of rupture of the ACL and PCL, arthroscopy is performed - one of the most minimally invasive operations. A torn ligament cannot be sutured - grafts or piece prostheses are used to restore it. Arthroscopy shows the greatest effectiveness after a course of exercises and physiotherapy, and this once again proves how important conservative therapy is. Usually the operation is done six months after the injury, but sometimes it happens even after a few years.

We also add that grafts can be of two types:

autografts (other tendons of the patient);

allografts (tendons from a donor).

The advantage of the second option is that the operation takes half the time, since the surgeon does not need to first cut out the graft.

Video - Conducting arthroscopy

Rehabilitation

Features of the rehabilitation course depend on what treatment was carried out. Methods of conservative treatment have been described above (the use of specific of them is possible only as directed by a doctor), so let's talk about postoperative rehabilitation.

The rehabilitation course consists of five stages and is designed for at least six months. For the convenience of visitors, the information is presented in the form of a table.

Table. Stages of postoperative rehabilitation

Stage Duration Description
First stage Weeks 1-4 Reducing pain, restoring joint function, achieving the ability to move without crutches. Approximately ten days after the stitches are removed, the plaster is also removed, and a circular plaster cast is put on instead. The performance of the femoral muscles is restored through electrical stimulation. The patient is regularly engaged in therapeutic exercises, he is given massages.
Second phase Weeks 5-10 When the goals of the first stage are achieved, you can proceed to the second. In turn, the goal of the second stage is to completely eliminate swelling, restore a full range of motion, improve muscle strength and control while walking. The exercises that are performed at this stage are aimed at gradually increasing the mobility of the knee, as well as strengthening the extensor apparatus. Gymnastics can be complemented by underwater massage and exercises in the pool.
Third stage Weeks 11-16 Muscular endurance improves, a person slowly but surely returns to functional activity, learns to run again. Active movements are performed (lunges, squats) and imitative exercises (use of the Alpinist simulator, exercise bike, treadmill, etc.).
Fourth stage Weeks 17-24 Restoration of the previous range of motion, elimination of the “residues” of pain and swelling, restoration of muscle endurance during long-term loads. Initially, simple exercises are performed in which the injured limb is affected vertically, but over time they are complicated by lunges, goose walking, walking on toes, running with acceleration and cycling.
Fifth stage (it is also called training) 0

The knee joint is often injured due to the load on it while walking, running, playing sports. Anatomically, the knee has two cruciate ligaments - posterior and anterior. The posterior cruciate ligament (often contracted by the PCL) functionally helps to keep the lower leg from moving backwards. Any damage to the posterior cruciate ligament of the knee joint is a consequence of a severe injury. The clinical picture of the condition depends on the complexity of the rupture. Treatment is usually conservative, but surgery is not uncommon.

Anatomical structure

The posterior cruciate ligament gets its name from the way the ligaments form a cross in their arrangement. The functional task is to keep the lower leg from moving. At its upper point, the PCS is attached to the internal condyle of the femur, and at its lower point, to a depression located on the tibia.

The ligament is formed by strong collagen fibers, which practically do not undergo stretching. Her body itself is formed by bundles: anterior-external, posterior-internal and a Humphi bundle, which is fastened to the meniscus. The first two bundles are stretched when the knee is in a bent state. When the joint is extended, the anterolateral fiber is stretched, and the posterior-internal, on the contrary, is stretched, helping to keep the knee in an extended position.

Important: injury to the PCL is much less common compared to damage to the anterior cruciate ligament. Due to the anatomical location, diagnosing a partial rupture of the posterior cruciate ligament of the knee or other damage is extremely difficult.

Causes of damage

Often in the materials about the damage to the PCL, there is such a thing as a sprain of the posterior cruciate ligament of the knee. However, from a medical point of view, such a definition of pathology is not correct. It would be more correct to speak of a break. It can be either at the microscopic level, if the stretching is of a small degree, or at the level of an individual collagen fiber or the entire ligament.

Violating the integrity of the posterior cruciate ligament is possible as a result of a strong impact on it. Among the mechanisms of development, the leading position is occupied by a blow to the shin inflicted from the front.

This often occurs during a traffic accident or professional sports.

Diagnosis of pathology

Most often, a rupture of the posterior cruciate ligament is accompanied by pain and swelling due to the accumulation of blood (this is called hemarthrosis). The moment of injury is often accompanied by a crack, the victims may note the instability of the knee. The last clinical sign is sometimes ignored due to the instinctive sparing regimen that is introduced by the person himself against the background of severe pain.

If a specialist suspects a rupture of the PCL, he, first of all, clarifies the mechanism for the development of an injury. Attention is also paid to the identification of possible concomitant injuries - a fracture, rupture of the meniscus, and other ligaments. Soreness is observed for several days after the injury, which negatively affects the possibility of special diagnostic tests and, accordingly, the detection of joint instability.

In some cases, instability is clearly expressed even in the acute period. This is especially true in relation to people who have an O-shaped lower limbs, as well as in the event of damage to other ligaments. Instability can be suspected by the described affected sensations - a feeling of sinking of the lower leg, disobedience of the knee joint.

During the initial examination, it is possible to suspect a rupture by the presence of abrasions, hemorrhages on the anterior surface of the lower leg. Often, a hemorrhage is also found in the popliteal fossa. It is important to remember that similar clinical phenomena are observed with meniscus rupture.

In order to make it possible to carry out a diagnosis, the victim is anesthetized by applying ice, taking drugs. After the pain syndrome decreases, several tests are carried out. Namely:

Front drawer test

The injured limb is raised above the couch and the lower leg is bent at the joint. The specialist gently pulls on the tibia. If a displacement is felt that is not noted during a similar procedure on a healthy limb, a rupture of the PCL is diagnosed.

Pivot-shift test

The specialist's left hand rests on the tibia closer to the knee joint. Then a slight push inward is carried out. In this case, the right hand pulls the foot to the other side. If the doctor's manipulations are not resisted, angulation of the posterior cruciate ligament is suspected.

Lachman test

The leg is bent at a slight angle and the lower leg is shifted down. Then a similar manipulation is carried out on a healthy limb. If the difference in the obtained data ranges from 3 to 5 mm, an injury is suspected.

You can confirm the diagnosis by conducting a hardware study - x-ray, ultrasound or MRI.

Modern medicine recognizes magnetic resonance imaging as the most informative and accurate diagnostic method. On the resulting images, you can see the angulation of the ligaments. What does angulated posterior cruciate ligament mean? In other words, the knee joint is bent in an unnatural position.

Experienced traumatologists can detect ligament angulation using ultrasound. Today, this method is also actively used if there is no access to an MRI machine.

Fact: MRI is a kind of "gold standard" for the most accurate diagnosis of the rupture of the ACL. The sensitivity of this method for this pathology ranges from 96% to 100%. In addition, magnetic resonance imaging can detect associated lesions.

Medical tactics

If during the diagnosis partial ruptures of the PCL were detected, the treatment is exclusively conservative. During the acute period, the knee joint is completely immobilized. After the edema is eliminated, all blood is removed from the cavity and measures are taken to relieve the pain syndrome. Wearing an orthosis helps prevent posterior displacement of the lower leg.

With a partial rupture of the ligaments, it is allowed to lean on the damaged limb. The range of motion increases gradually. Mandatory physical exercises aimed at training the back and front muscles.

Conservative treatment is also used for isolated rupture of the posterior cruciate ligament. If the gap was complete, the limb is fixed in an extended position.

It should be remembered that today's studies have shown that conservative treatment has negative consequences. In particular, the persistence of the pain syndrome even 15 years after the injury.

With this in mind, a more effective and more commonly used method today is surgical intervention. It is carried out in different ways, depending on the severity of the damage. After the operation, there are practically no negative consequences, provided that all the recommendations of the attending physician were followed.

Rupture of the cruciate ligament is a pathological condition that develops as a result of trauma to the knee joint. This ACL injury is one of the most dangerous, but with its timely detection, provision of assistance and proper treatment, it will not carry any consequences for a person. He will be able to continue a normal life. Most often, the torn cruciate ligament of the knee occurs in people who are actively involved in sports, especially tennis, basketball and football.

The cruciate ligamentous apparatus is a strong anatomical formation that is responsible for the full functioning of the knee joint, and also controls the movements of the articular joint in a strictly designated range. If the range of motion increases for any reason, then stretching or even rupture of the ligamentous apparatus is possible. There are two ligaments in the knee - anterior and posterior. They got their name due to the fact that if you look at the knee from the front, they form a cross. Under the influence of adverse factors, both the posterior cruciate ligament and the anterior cruciate ligament can be torn.

The symptoms of a rupture are usually very pronounced - the knee swells and an intense pain syndrome appears, the body temperature rises locally. In addition, at the moment of rupture, a person may hear a crackling sound. It is only a traumatologist who can accurately determine that a rupture has occurred after an examination and the appointment of certain methods of laboratory and instrumental diagnostics. It is recommended to treat a rupture of the anterior cruciate ligament of the knee or the posterior cruciate ligament in stationary conditions. Doctors resort to both non-invasive therapy and operable intervention.

Causes

More often in medical practice, a rupture of the anterior cruciate ligament of the knee joint is detected. And usually it is associated with trauma. Somewhat less often, inflammation in the area of the articular joint can contribute to this. Rupture of the posterior cruciate ligament is much less common.

Causes of this pathological condition:

fall of a person from a height;
sharp movements in the knee joint. A gap can occur during intense jumps, an abrupt stop after running, a sharp extension, and so on;
stumbling;
a blow to the knee region, falling on its front or back. Worst of all, if there is a direct blow. Because of it, a complete rupture of the anterior cruciate ligament can occur;
road accident;
the course of degenerative or inflammatory processes in the knee joint, which also affect the ligamentous apparatus.

Predisposing factors for stretching or rupture of the ligamentous apparatus:

inadequate development of muscles in the lower extremities;
some features of the human skeleton;
human hormonal background. Clinicians note that such an injury is more often diagnosed in the fair sex.

Degrees

Based on how badly the ligamentous apparatus in the knee joint was damaged, three degrees of rupture are distinguished. Each of them is characterized by its own symptoms, and depending on the degree, treatment tactics are also selected:

microfracture. In this case, there is a violation of the integrity of the ligament only in a certain part of it. The symptoms are not too pronounced, the general condition of the patient does not suffer. This stage is treated without surgery. There are no complications with proper treatment;
partial break. Also in the medical literature it is called a subtotal gap. In this case, about 50% of the fibers are damaged. Symptoms are more pronounced, the functioning of the knee joint is disturbed. Treatment of rupture is only complex. If such an injury occurred to an athlete, then for a full recovery, an operable intervention will also be required;
complete break anterior cruciate ligament. The ligament is torn completely and the knee joint cannot fully function. A complete rupture of the ligament of the knee joint treatment involves only surgery.

Symptoms

The intensity of the symptoms of rupture of the anterior cruciate ligament directly depends on how much the integrity of this anatomical formation will be violated. Most often, the presence of this pathological condition in a person can be suspected by the following signs:

during an injury, a person hears and feels a crunch in the area of the knee joint;
local increase in body temperature;
at the time of the injury, a strong pain syndrome appears, which intensifies as the person tries to move the leg (if the ligament is completely torn, the limb ceases to perform its supporting function);
the knee joint swells;
the limb is unstable;
hyperemia of the skin at the site of injury. There may be bruising and bleeding;
manifestation is not excluded. This is a pathological condition that is characterized by the accumulation of blood in the joint.

In the event of the appearance of such signs, it is important to provide first aid to the patient until the delivery of the patient to a medical facility. The first thing to do is to completely immobilize the leg so as not to injure it even more. The affected knee is fixed with an elastic bandage or an ordinary tight cloth. Be sure to apply cold to the affected area and the patient is given an anesthetic tablet to reduce the manifestation of pain.

Diagnostic measures

Only a qualified doctor traumatologist can detect the presence of a rupture of the anterior cruciate ligament, after interviewing the patient and carefully questioning him. To assess the degree of gap, some instrumental examinations are assigned, in particular the following:

radiography of the affected limb;
ultrasound examination of the articular joint;
MRI is the most informative technique that allows you to identify the presence and extent of the gap.

Therapeutic measures

Many assume that the only way to close the gap is through an operable intervention. But actually it is not. For the treatment of this condition, both conservative methods and surgical intervention are used.

Conservative treatment is used in the treatment of rupture in children, as well as in the elderly. In addition, with the help of non-invasive methods, a partial tear is treated, which minimally affected the functioning of the articular joint. The affected leg is fixed and provided with maximum rest. If there is an urgent need, then the doctor can even plaster it. Some medications are prescribed:

anti-inflammatory;
painkillers;
restorative;
hemostatic.

The second stage is the restoration of the functioning of the affected joint. For this purpose, the patient is prescribed massage, physiotherapy, exercise therapy, wearing special orthopedic devices.

Operable intervention is indicated if conservative therapy is ineffective or if there is a complete rupture of the ligamentous apparatus. It is important to know that suturing is not able to restore the integrity of the ligament. Therefore, in order to normalize a person's condition, special ligament prostheses or transplants are implanted into the knee.

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Chondromalacia of the patella is a pathological process that results in the destruction of the cartilage of the posterior surface of the patella. In the people, this ailment is often called "runner's knee." Most often, the disease is diagnosed in women after 40 years. But younger people are no exception.

Contracture is a disease that is characterized by a persistent limitation of motor function. This pathological process can be caused by infectious diseases, diseases of the musculoskeletal system and muscle tissue, injuries and some medical measures.

Well-known to many people, mostly the elderly, are joint pains. They are caused by malnutrition, physical inactivity, stress, heavy physical exertion and other factors. Quite often, in the elderly and in a small percentage of young people, osteoarthritis of the shoulder joint occurs - a chronic ailment that causes serious deformations of the cartilage, as well as the tissues adjacent to it, and bones. It has a progressive type, and symptoms may not appear for years, and then sharply worsen. The most common symptoms are pain in the shoulders after a long stay at low temperatures, as well as after lifting heavy objects.

ARTHROSCOPIC PLASTY OF THE POSTERIOR CRUCIATE LIGANIUM OF THE KNEE

Rupture of the posterior cruciate ligament (PCL) is one of the most severe injuries of the knee joint.

It is quite difficult to damage the posterior cruciate ligament, most often it happens as a result of a car accident (hitting the front of the lower leg with a car bumper) and in high-speed sports (during a fall on an obstacle in skiing and snowboarding, in team sports when colliding with another player .) In this regard, the rupture of the PCL is rarely isolated and is accompanied by damage to the anterior cruciate, external and internal lateral ligaments. The PKL is always damaged by dislocation of the lower leg, as it is the main stabilizing structure of the knee joint.

The posterior cruciate ligament consists of two powerful bundles, if one of the bundles is torn, the ligament can grow together on its own, the patient is prescribed conservative treatment, including wearing a special knee brace for two months from the moment of injury.

With a complete rupture of the PCL, gross violations of the biomechanics of the knee occur.

With any flexion of the knee joint, the lower leg is displaced posteriorly. Instead of rotating in the knee joint during flexion, the lower leg slips and moves backward. As a result, when walking, only the anterior part of the lower leg and the posterior part of the femoral condyles are loaded, the rest of the load is not involved. At the same time, the load on the cartilage increases thousands of times, and the knee joint is completely destroyed in 5 years. In addition, when the lower leg is shifted back, the load in the patellofemoral joint increases, the cartilage under the patella wears out just as quickly, a crunch and pain in the knee joint occur.

Diagnosis of damage to the posterior cruciate ligament begins with an external examination, the retraction of the lower leg back is often determined, a number of patients may spontaneously displace the lower leg. Examination reveals posterior drawer and false anterior drawer tests. On radiographs in lateral projections, the degree of displacement of the lower leg back is determined. In some cases, an x-ray with a load is performed. MRI is the most accurate method for diagnosing a ruptured posterior cruciate ligament.

Treatment of a torn posterior cruciate ligament is usually performed arthroscopically.

A plasty of the posterior cruciate ligament is performed using a tendon graft of the semitendinosus and gracilis muscles. This is the most gentle technology using our own fabrics. This technique is owned only by experienced surgeons with extensive experience in arthroscopy, such operations are the highest aerobatics of arthroscopic surgery.

With a small incision of 2-3 cm on the lower leg, the tendon is harvested, it folds 4 times and a posterior cruciate ligament graft is formed from it, comparable in strength to the normal posterior cruciate ligament. Under arthroscopic control, tunnels are formed in the condyles of the femur and lower leg, into which the graft is inserted and fixed with absorbable fixators consisting of lactic acid and hydroxyapatite, which, as the screw dissolves, helps the new ligament grow to the bone.

Rehabilitation is the key to the treatment of posterior cruciate ligament tears.

For a month, the lower limb is fixed in a special brace, which relieves the load from the ZKS.

It is impossible to bend the leg completely for 6 weeks.

You can bend the leg passively with the support of the second leg, and you can unbend actively, straining the quadriceps muscle.

The special articulated knee brace must be used for up to 4 months.

Swimming after 3 months

Running after 4 months

Sports without restrictions after 6-8 months from the date of surgery.

Successful treatment of the rupture of the PCL is a collective and synchronous work of the patient himself, the surgeon and the rehabilitator.

An injury to the posterior cruciate ligament of the knee occurs when the tibia moves backward. The ligamentous apparatus is designed to control the range of motion. A huge number of receptors gives a signal to the nervous system to stop muscle contraction.

Powerful ligaments form the support of the knee in the form of two crossed ribbons. Posterior - helps to keep the tibia strictly above the femur, providing the correct axis of the joint. Ligament injury often leads to knee instability.

The posterior cruciate ligament (PCL) is less frequently injured than the anterior because of its greater thickness and strength. The most common mechanism of injury is direct impact on the anterior part of the lower leg.

Rupture of the posterior cruciate ligament of the knee joint requires the application of significant forces. The most common situations of injury:

Often, skiers, basketball players, and football players receive such injuries. Injuries to the posterior cruciate ligament are accompanied by damage to the nerves and blood vessels.

Symptoms

Unlike a snap that is accompanied by severe pain, as with an anterior cruciate ligament tear, an isolated ACL tear can cause swelling and mild pain in the knee. Symptoms disappear within a few days or a week.

The main signs of damage to the posterior cruciate ligament are as follows:

mild pain that increases with time;
knee instability, weakness in it;
immediately after injury;
stiffness due to swelling;
difficulty walking and going down stairs.

The symptoms can be so subtle that most people don't notice the problem. Symptoms increase over time, pain becomes severe, and the knee becomes unstable without treatment. Bruising in the popliteal fossa indicates tissue rupture.

After any injury, it is important to visit a traumatologist to diagnose a ligament problem. Initial swelling in the joint can make it difficult to assess the extent of damage. After the first signs of inflammation and pain subside, you should consult a doctor again.

Diagnostics

The traumatologist asks about complaints, their origin, conducts an examination. It is important to talk about how the injury occurred, to describe the position of the leg at the time of injury. Surgeons use the "drawer" syndrome to diagnose PKL injury. With the knee bent, the doctor pushes the tibia back. A large amount of motion indicates weakness or damage to the PCL.

The doctor examines all the structures of the damaged knee and compares it with a healthy joint. So it is possible to find other injured ligaments or cartilage. X-ray and MRI reveal damage to bones and soft structures, respectively.

If the diagnosis reveals angulation of the posterior cruciate ligament, what does this mean for the patient? A diagnostic criterion that helps establish a diagnosis. Depending on the integrity and other ligaments, a decision is made about the operation.

The spectrum of injury to the PCL includes contusions, sprains, or tears. Injuries are classified according to the range of tibial displacement that occurs when the knee is bent to 90 degrees. In extreme cases, the ligament is avulsed—completely detached from the bone.

ZKS damage classification:

first degree - partial rupture;
second degree - isolated complete rupture;
third degree - rupture with other concomitant injury.

When diagnosing a sprain, one of two diagnoses is made:

Grade 1 sprain – The ligament is slightly damaged in a Grade 1 dislocation. The tissue is stretched but still maintains the stability of the joint;
second-degree sprain - stretching that leads to a partial tear of the ligament.

Complete rupture of the PCL and simultaneous damage to other structures of the knee usually requires surgery to restore joint function.

Treatment

If the posterior cruciate ligament is damaged:

Unload the limb until swelling and soreness subside. The use of crutches is recommended.
Apply an elastic bandage or brace to stabilize the joint. Support is needed to keep the structure in its normal position during regeneration.
Physiotherapy helps to restore movement and strength of the limb.

An operation to restore the ligament and other structures is needed for dislocations of the 2nd or more degree. For milder injuries, only immobilization and rest are required for a recovery time of 2-3 weeks. Many patients continue to live and move with a damaged ligament. But if injured at a young age, instability can appear in old age or when physical activity is suspended.

conservative methods

First aid is related to resting the knee joint:

You can use Ibuprofen, Naproxen to reduce pain and swelling. Ointments such as Troxevasin are applied to reduce swelling, Diclofenac - against inflammation.

Surgery

Surgical reconstruction of the posterior cruciate ligament is rarely performed - only for third-degree tears. Due to the technical complexity of the operation, some orthopedic surgeons do not see the point in performing the intervention. On the other hand, surgery is needed for the following indications:

rupture of the ligament with a fracture of the detachable type (fragment of the tibia or femur);
lack of progression in conservative therapy;
urgent need for joint function in athletes.

Surgical arthroplasty is required for damage to several ligaments, as well as lost stability of the knee. For reconstruction, a graft taken from a tendon in another part of the body is used.

Rehabilitation

Regardless of whether the patient needs surgery or not, rehabilitation is mandatory. help restore joint function:

Only after a month you can load the operated leg, and after three - run and do active exercises.

Be sure to take care of the massage, which improves the blood supply to the joint. You can visit an osteopath after surgery to remove the resulting adhesions.

Conclusion

An injury to the posterior cruciate ligament is a rare knee injury. Even a slight tear can lead to joint instability over time. The limbs require rest, immobilization and, if indicated, surgery. Exercises help to compensate for the weakness of the injured ligament with the muscles of the thigh and lower leg.

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