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Offline mofussy

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PCL Surgery
« on: February 25, 2005, 12:03:53 AM »
Hey everybody,

I injured my right PCL last summer.  I was rafting on the Arkansas River and, long story short, smashed my knee into a boulder.  Anyway, I went to an OS who did an x-ray and MRI.  He said it was a pretty significant injury, but felt that therapy would probably do the trick.  He gave me a DonJoy sports brace and 2 months of therapy.  It helped, but since completing it 6 months ago I haven't been able to keep up the same aggressive workout schedule.  And I'm guessing that as a result, the symptoms are returning.

I went back to the OS to discuss surgery.  The procedure he described involves attaching a new PCL ala allograft to my bones with screws.  I'm not sure if he means to remove the old damaged PCL and replace it with this new tissue, or if he's going to install the new one on top and mesh the old stuff with it.

I didn't know much about the subject during my last visit, and therefore didn't really know what to ask, so I scheduled another appointment a couple months down the road.  Since then I've done a little research online and haven't been able to find anything about attaching an allograft with screws.  It seems like the most common course of action is to attach the graft to the existing damaged tissue to promote growth.  Right?

So I'm wondering if what my doctor is talking about is normal or if it's an extreme course of action.  I've already got plenty of questions to ask him, but if anyone could share their stories regarding PCL repair or point me to some good references, I'd really appreciate it.  My next appointment is a month away, and I've got to do something.

Colorado, USA

Offline Nick_Knack

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Re: PCL Surgery
« Reply #1 on: February 25, 2005, 12:47:49 AM »
Hi Matt,

Since you are a in Colorado (you are very lucky), I would recommend you go see Richard Steadman, one of the best knee surgeons in the U.S.  Check out his website (search: Steadman-Hawkins Clinic).

 What I know about the PCL:

1) You may want to give it more time to heal.  The PCL is in a place in the knee where there is a much better blood supply than where the ACL so often it heals non-operatively.  Check out some of KD Shelbourne's articles on the PCL. There is a national medical website which gives you access to searching articles.   I am not exactly sure how long you should give it before going the operative route.  Many surgeons treat the PCL non-operatively.

2) If your PCL is symptomatic, be careful with this surgery because it is so much less common than the ACL, many docs simply don't have sufficient experience in doing them.  It is also in a part of the knee which is harder to access than the ACL.

This is why I would advise to go to a very experienced knee surgeon like Richard Steadman.  He will treat you appropriately. 

Frank Noyes has also published on PCL surgery techniques.  He is in Cincinnati.


Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline mofussy

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Re: PCL Surgery
« Reply #2 on: February 25, 2005, 10:37:40 PM »
Thanks Nick.  I've heard Dr. Steadman's name from some other people too - I'll definitely check him out.  And thanks for the references - lots of good reading.