PCL

Tests

Subjective

Objective

Posterior Lachman test.

Posterior draw test. Only done when swelling free.

MacMurray's test. Meniscal ax.

Combination injury: more significant swelling, pain, a feeling of instability, limited range of motion and difficulty with mobilisation

Observation

Isolated PCL: Symptoms are often vague and minimal, with patients often not even feeling or noticing the injury. Minimal pain, swelling, instability with full ROM and normal gait.

Often occurs in ages 20-30.

Common in sport and mainly occur in conjunction with other injuries.

Clear MOI: direct blow to the anterior aspect of the proximal tibia on a flexed knee.

Research

Why this and nothing else?

Differentials

Pathology

Treatment

PCL prevents tibia from posterior displacement in relation to femur. Major stabiliser of knee joint.

Graded 1-3. Limited damage, partially torn and complete tear.

Less common injury, that is sustained to the PCL. Twice as thick compared to ACL.

General rehab program would focus on building weight bearing capabilities and quadriceps strengthening.

Conservative for grades 1 and 2.

Two weeks of relative immobilisation of the knee (in a locked range of motion brace) is recommended by orthopaedic surgeons.

click to edit

Meniscal injury.

MCL/LCL injury.

ACL injury.

Special testing.

Important to identify other damaged structures as likely occurred in conjunction.

MOI would be clue.

Palaption.

AROM

Strength testing.

Sag sign.

Valgus and Varus stress test.

Ottawa knee rules: refer to ACL.

Begin with weight baring, ROM and quad strengthening.

Progress to weaning off brace, full weight baring, proprioception, balance and coordination work, once strength and endurance progress to agility.