Key Points about PCL Surgery

  • PCL surgery is the surgical repair of the posterior cruciate ligament (PCL) after a sprain, strain, or tear.
  • The PCL is located in the back of the knee. The PCL connects the thigh bone (femur) to the shin (tibia). The PCL works with the anterior cruciate ligament (ACL) to stabilize the knee.
  • PCL surgery might be considered for someone who has severely torn their PCL or damaged multiple ligaments.
  • PCL surgery is typically reconstructive surgery. During surgery, an orthopedic surgeon will remove the torn PCL and replace it with a tissue graft, either from your own body or from a deceased donor.
  • Recovery from PCL surgery can take several months to a year

Overview

PCL injuries are not common, but If you sustain a severe PCL injury, your doctor may recommend PCL surgery. PCL injuries fall into four grades:

  • Grade I - The PCL is partially torn.
  • Grade II - While partially torn, the ligament is loose.
  • Grade III - The knee is unstable because the PCL is completely torn.
  • Grade IV - Both the PCL and other ligaments in the knee have damage.

Many Grade I and grade II injuries will not require PCL surgery. Surgery is often recommended when there is a complete tear of the PCL, if there is also damage to surrounding ligaments, or if the knee has become dangerously unstable. Orthopedic surgeons perform PCL surgery by removing the damaged PCL and replacing it with healthy tissue. This tissue can come for your own body or from a donor. Recovery from a PCL injury and PCL surgery can last as long as a year. Severe PCL injuries requiring PCL surgery are often the result of direct trauma to the PCL from a car accident or sports injury.

PCL surgery candidates

Candidates for PCL surgery:

  • Have grade III or grade IV PCL injuries
  • Are experiencing serious instability of the knee
  • Have multiple injuries to the knee in addition to PCL tears
  • May be experiencing a pulling of the ligament
  • May not have full mobility because of the injury

PCL surgery risks

There are risks associated with all surgeries. The risks of PCL surgery include:

  • Reactions to anesthesia
  • Infection
  • Nerve damage
  • Damage to blood vessels
  • Pain
  • Swelling
  • Numbness at the surgical site
  • Blood clots

PCL surgery preparation

Your health care team will give you instructions to prepare for PCL surgery. They may include:

  • Having bloodwork several days prior to check for infection, risk of blood clots, organ function, and overall health
  • Stopping the use of certain medications
  • Quitting smoking
  • No eating or drinking past a certain time the day before surgery
  • Gather everything you will need post-surgery, including ice packs, brace, crutches, and medication

PCL surgery expectations

PCL surgery can often be performed in an outpatient surgery center. The length of the surgery depends on how severe the injury is; however, most PCL surgeries last up to two hours. You will be put under general anesthesia during the procedure and may be in some pain when you awake after PCL surgery. Many patients are able to return home the same day. You will likely be wearing a stiff brace on the affected knee for several days or weeks.

After PCL surgery

Recovery from PCL surgery varies from person to person. In general, full recovery after PCL surgery can take up to a year. Your rehabilitation should include a progressive program of physical therapy to address range of motion, strength, and balance. Immediately after PCL surgery, you will have a period of time -- five to six weeks -- when you should not bear any weight on your leg. You will then likely progress to using a brace on the affected knee and crutches. If there are no complications after approximately three months, you may be able to proceed with a light physical activity program such as walking or swimming. Patients generally return to full activities between nine and 12 months after PCL surgery.