PCL Injury

PCL symptoms are often more subtle than an ACL tear, and the injury can be missed at first. Common signs include: Mild to moderate swelling — that develops over the first day. A vague sense of instability — particularly going down stairs or slopes. Aching at the back of the knee — and discomfort when kneeling. Stiffness — and difficulty pushing off when walking quickly.

A direct blow to the front of a bent knee (dashboard injury). Falling onto the knee with the foot pointed down. Hyperextension or a severe twist, often with other ligament damage. Contact and collision sports such as football and rugby.

The posterior drawer test assesses how far the tibia sags backwards, which grades the injury. An MRI confirms the tear and — crucially — checks for the associated ligament and meniscus injuries that change the treatment plan. X-rays exclude any bony avulsion.

Unlike the ACL, most isolated PCL injuries heal well without surgery, because the ligament has a good blood supply and the surrounding structures help it recover. Rehabilitation: Most isolated tears are treated with a focused quadriceps-strengthening programme, sometimes with a brace, restoring stability over a few months. Reconstruction: Reserved for complete tears with other ligament damage, or persistent instability — the ligament is rebuilt arthroscopically with a graft.

With a structured programme, most patients with an isolated PCL injury return to full activity within three to six months and report a stable, comfortable knee. Where surgery is needed for a combined injury, recovery is longer and is staged carefully alongside the other repairs.