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Author Topic: Complete tear of the posterior cruciate ligament (PCL)  (Read 2330 times)

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Offline GSXR750

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Complete tear of the posterior cruciate ligament (PCL)
« on: July 01, 2006, 12:05:50 AM »
 ???

On 6/24/2006 I was hit by an auto while riding my motorcycle.  The driver was at fault and now I discover I have a complete tear of the PCL.  I'm lucky that no bones were broken but there are other injuries.  I'm a 51 year active male in very good health with no other health problems.  The "Impressions" section from my MRI reads:

1) Complete tear of the poterior cruciate ligament.
2) Avulsion fracture, lateral collateral ligament at the femoral attachment.
3) Myotendinous sprain, popliteus muscle.
4) Horizontal oblique tear, medial meniscus posterior horn.
5) Knee joint effusionand soft tissue edema.         

I am hoping you could advise as to if this injury is something I should consider repairing. 

Thank you for the consideration.

Jess

Offline emphatic

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #1 on: July 01, 2006, 03:58:57 AM »
Jess,

Did the doctors actually give you a choice not to repair it?? (She asks, incredulously.) Or, are you wondering if you can go against medical advice and get away without repairing it?

Three things pop out:

Complete PCL tear
Avulsion tear of LCL at the femoral attachment
Oblique tear posterior horn of the medial meniscus

You have a limited window of time to fix the avulsion fracture tear of the LCL. The bone fragment will die eventually and they won't be able to attach it again. Basically, the ligament tore off the bone, taking a piece of bone with it. This ligament runs along the outside of the knee and it tore off the bone at the top part -- where it attaches to the femur (thighbone). That's bad.

People can live without a PCL if they're willing to give up any activity requiring reasonable mobility. You can't have two ligaments gone, though, and expect to have stable knee. Not to mention the vastly increased risk for severe osteoarthritis.

Add to that a posterior horn medial meniscus tear, and you have a pretty screwed up knee. That kind of tear is really good at flapping up into the joint and causing locking -- which hurts like bloody hell. The meniscus tear will add to the knee instability and will, if left untreated, cause significant osteoarthritis.

I'd be shocked if you can walk on it without a fair bit of pain, and once the swelling goes down, you'll have the wondrous joy of walking around and suddenly finding yourself face down in the dirt, wondering how that happened. Your knee just gave out... oops.

Yes, you need to get this fixed, preferably ASAP. Then, after you get it fixed, do your rehab properly so you aren't dealing with a severely painful knee for the rest of your life. Really.  :)

Good luck with it.

Meg

Offline Audice

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #2 on: July 01, 2006, 11:30:00 AM »
Jess ~ I have to agree with Meg that having 2 of your 4 major knee ligaments missing is going to make a big difference in your quality of life. Life is interesting enough w/o an ACL but it would seem to me you'd want more stability than you're going to have if you don't consider repair of at least one of those ligaments. Wishing you well...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline GSXR750

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #3 on: July 01, 2006, 04:50:14 PM »
Thanks for the information.  I go to the doctor Wednesday for of the MRI.  I live in Salem Oregen and have choosen a doctor in Beaverton.  His name is Paul Puzzis.  Do you know anyone in the northwest that is good at fixing knees?

Thanks again,
Jess 

Offline Audice

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #4 on: July 01, 2006, 06:50:00 PM »
Jess ~ Have you checked the Kneegeek website. You'll find a listing of knee surgeons by country & state. There may be some listed for Oregon...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline GSXR750

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #5 on: July 01, 2006, 07:29:19 PM »
Thanks Ellie, I'll investigate the site. :)

Offline emphatic

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Re: Complete tear of the posterior cruciate ligament (PCL)
« Reply #6 on: July 01, 2006, 08:13:40 PM »
Jess,

This is a pretty significant injury, so I would highly suggest trying to find the best possible surgeon -- preferably one who primarily works on knees, and/or has considerable experience with knee trauma (as opposed to sports injuries). You really, really want the best possible person doing this surgery for you.

Places to look:

Ask around to find one of the larger orthopedic practices in the area, even if you have to drive a bit to get there. See if there's a practice which handles local sports teams at the college and pro level, or which is associated with a major teaching hospital (even better if that teaching hospital is associated with a large university with a big Div 1 sports program).

If you've got any friends or acquaintances (or friends of friends) who've had knee surgery, ask who they went to and whether they were happy with their results.

Look in the phone book (or online at one of the phone book websites) covering the largest metropolitan area possible near you, and just see if any of the ortho practices have large ads which list their specialties. I don't suggest finding a doctor from the phone book, but it's a good way to get a list of possible names, so you'll recognize them when you hear them again.

If you have a primary care doctor (GP or internist) whom you have a good relationship with, ask who they'd go see. If they don't know, ask if they'll make some phone calls to colleagues to see who the colleagues would recommend.

I know this sounds like a lot of extra work, but you really, really, really want to have to best possible person working on your knee. Your age and the nature of your injury don't give you a lot of wiggle room for bad results.

Good luck... and please feel free to come back with any questions. We're happy to help.

Meg















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