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Author Topic: Partial PCL Tear - Healing with No Surgery?  (Read 13611 times)

Offline Valkyrie

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Partial PCL Tear - Healing with No Surgery?
« on: August 22, 2006, 03:09:38 PM »
I've been reading a lot of these posts, and cannot find a good answer to my problem.

first, some history.

I fell of my bike at age 30 (dumb, I know) and landed on my right knee, flexed at a 90 degree angle.  The ER docs did not catch my injury, but after 1 week of immobilization and RICE, and 2 weeks of hobbling around on it with an ACE bandage and an off the shelf brace, the pain was still very bad.

Long story short, the Physical Therapist performed the posterior drawer and sag tests, and they were positive, which led to ortho, and then the MRI, and then back to ortho, and back to Physical Therapy...  Bottom line, I have a 50% tear (isolated) of the PCL.  Most of the pain in my knee was originating from the fluid in the sac around my kneecap, and with the PT, that seems to be lessening and the stiffness gets a little better every day.

My Ortho doc is military, so they really don't have a lot of time to explain things in detail.  My question that I can't find a good answer to is the recovery rate of a partial PCL tear.  Or the spontaneous healing rate.  There are a few articles out there, but there is a charge $30.00 plus to read the thing.  My re-eval is in 5 months with ortho, probably another MRI.  Ortho won't even discuss surgery before that time.

Has anyone's PCL recovered (as in re-grown, back to normal running/playing sports, no pain) without surgery?  I understand with a complete PCL tear this is highly unlikely, but with a partial, does anyone know?  I was very active before my accident, and am currently working on gaining my thighs of steel from the crazy amount of quad strengthening exercises my PT has me doing.  I'm hoping to be able to get back to running soon, and ski season is 5 months away.

Some advice/experience please.
Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

Offline henri

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #1 on: August 22, 2006, 05:12:56 PM »
I have a friend who had his PCL done,thought he also had his MCL and ACL done,so it was more difficult.But he is running now again after 1 year and playing a little football etc.I think you can have this done,but first try to recover from it without the surgery.Make those  thighs of steel for sure and hopefully they will hold.I am sure your PCL recovers atleast a little,but not the whole thing.
unhappy triad

Offline Valkyrie

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #2 on: August 23, 2006, 07:52:51 AM »
He had surgery though, right?  I'm trying to see if anyone has managed to AVOID surgery, and had a full or near full recovery from a partial tear.  The way it was explained to me was the PCL has a sheath around it, so it has a blood supply (unlike the ACL).  Since half is still hanging on, there is a framework, or a "lattice" for the other half to grow back.  Do I have this right?

My Ortho doc was not excited about the idea of a PCL surgery at all.  Evidently, it's a very difficult procedure.  I wouldn't be able to have it done in the Army hospital anyway, I'm a civilian who works for the military, so I would have to go to a German hospital.

But then again, I'm told one of the best knee surgeons in Europe works in the city I live in, and he was one of the publishers of a PCL tear knee study.

I'm glad your friend is back to running, and I hope you have a full recovery too!

Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

Offline henri

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #3 on: August 23, 2006, 11:22:01 AM »
He had a operation yes, thought he also had a bad dislocation of the knee,full tear of PCL, so he didnt have any choice,but you can try to solve this problem with PT,i think it might just work.There are plenty of guys who have recovered with partial ACL tear after the surgery.
unhappy triad

Offline Valkyrie

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #4 on: August 23, 2006, 12:29:22 PM »
I keep reading about all these US football players who play in a partial PCL torn knee, and wonder how the hell they do it.  I turn the wrong way and pull my hamstring and I feel like I'm going to die from the pain.  I know they have a very good recovery rate from surgery, but again, avoiding that if possible.

I know that with enough work I'll have a functional knee - I'm already walking around with no cane or crutch, and the knee is pretty stable, it's just when I move wrong that it hurts.

But I want more than a functional knee - I really need to get back to running.  and skiing.

AHH! I read back through this and I think I was whining there... sorry. 
Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

Offline scoffs

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #5 on: August 23, 2006, 03:34:48 PM »
Hi

I had a partial PCL tear and it re-habbed well.  Took about 5 or 6 months tho.  Eventually I had surgery as I also had ACLR when that was fixed they told me my pcl had healed fine.

I think you can totally avoid surgery, you just need to work on your muscles.  My OS told me that PCL injuries can be treated non surgically in 90%of cases. There are loads of examples of professional atheletes that have PCL injuries and still compete at a high level.

Hope that helps
ACL Recon (Hamstring) May 03
PLC Recon (Donor) Sept 06
Ran London Marathon :-) April 09

Offline stevew

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #6 on: August 23, 2006, 08:23:49 PM »
I had a PCL reconstruction done at Ft. Bragg NC, way back in 1987.

Offline Valkyrie

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #7 on: August 24, 2006, 07:20:03 AM »
Thanks - that does help.  I was figuring a year to get back to normal, assuming worst case senerio and my re-evel does not go well.

I'll just do what I've been doing, keep up with the PT and make sure I do it on my own.  been a bit of a slacker this week...



Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

Offline Valkyrie

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Re: Partial PCL Tear - Healing with No Surgery? AHA! answer!
« Reply #8 on: August 24, 2006, 12:51:22 PM »
I just had to find the correct site!  This is a study/outline of a typical (no issues) rehab plan, one for surgical, and one for non-surgical.

http://www.emedicine.com/SPORTS/topic105.htm

Bottom line, about 4-5 months to get back to running, and about 1 year to get back to normal.  Any one disagree with what these guys had to say?
Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

Offline sbwestin

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #9 on: August 25, 2006, 12:29:51 AM »
The standard of care for partial PCL ruptures is conservative treatment. Formal graft reconstruction is not required - but rehabiltation is an abolute must with an experienced therapist for patients desiring to return to any type of athletics. It will be important for you to become educated in exercises that are safe and those that should be avoided for your injury.

The "cutoff" in terms of partial vs. complete PCL rupture in the medical literature is 10 mm of increased posterior tibal translation. That is the key...it really isn't possible without an arthroscopic examination to tell how much of the ligament has been disrupted (i.e., 30% vs. 50% vs. 75%).

Finally, modern PCL reconstruction involves double-bundle grafts that more precisely replicate the PCL's native behavior. I'm just providing this information in case you should unfortunately "complete" the tear and have to think about surgery. Here in the U.S., there are major knee centers which perform successful PCL double-bundle reconstructions on an almost routine basis.

Good luck,

SueBW
Lateral release x 2
Bilateral arthroscopic subacromial decompression, distal clavicle resection
Repair tennis elbow
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Offline hockeygirl4

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #10 on: August 30, 2006, 08:41:40 PM »
I was playing softball in 1997 and covering home plate for a throw...thought the runner was going to slide but instead she just ran right into my outstretched left leg head on.  Went to the doctor and they said it was a bruise, got a 2nd opinion and same diagnosis. Thought I was overreacting but I was in an immobilizer for a month! Never really healed properly...not expecting it to since I thought it was nothing more than a sprain.  Went back in 2003 to a new doctor due to increasing pain, locking, snapping, and laxity.  MRI revealed what he described as 100% tear of the PCL. Suggested PT, never went because I play ice hockey, volleyball, softball, and work out at the gym..why bother? Young, dumb, and ignorant I was.  2005 saw a new OS, who is the doctor for local pro sports teams and he sent me for therapy again. I went, it felt better, but seriously, am I going to have to do PT for the rest of my life to alleviate the knee pain? They won't operate on it, probably because it's been 9 years.  I have learned to deal with the pain and stop wasting money going to the doctors who won't help me.  >:(
Grade I/II PCL tear - conservative treatment and stabilizing brace for sports

Offline stucasscelts7

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Re: Partial PCL Tear - Healing with No Surgery?
« Reply #11 on: September 22, 2006, 03:11:01 AM »
i totally snapped my pcl playing football and played for months after it but as the pain gradully got worse and the swelling i ended up struggling to train a much and as that happened my legs muscle got weaker and i eventually couldnt run so much and lost all my pace as was getting swelling all the time, i now cant play and been told i will never play again, i heard that a small tear can heal over years and it should be fine, if u can build your leg up strong enough u should be ok but i would leave it a year in case u do it further damage and get the bad news i got, i know pro  players that have slight tears or full and they never have recovered or came back and broke down again

Offline Valkyrie

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Re: Partial PCL Tear - Healing with No Surgery? UPDATE
« Reply #12 on: September 25, 2006, 03:34:32 PM »
All - Thanks for the great advice!  It's been a month now - and the pain is slowly fading.  I have good days and not so good days.

The re-eval with the PT went well - I am cleared to try skiing - with a brace, only on groomed bunny slopes, but it is a start. i ordered teh donjoy extrere armor one.  damn that was expensive.  it had better be worth it.

I have also started my walk/run program.  I found out i could walk at a 15 minute mile pace for 2 miles without pain.  which is the first milestone of the run walk program.

3 months ago when i was hobbling around on a cane with my knee braced up i could barely believe i'd be getting ready to start jogging again in a few weeks.

hang in there - do your PT!
Partial PCL Tear Right Knee
Occurred June 2006
Currently working on Thighs of Steel!

 















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