PCL reconstruction is generally undertaken using a hamstrings tendon from the same patient, which is folded to produce an appropriate length and width.
Grading posterior cruciate ligament injuries
PCL injuries are graded on a scale of I-III.
"....Grade I (partial tear) - 1-5mm posterior translation. Tibia remains anterior to femoral condyles....Grade II (complete isolated) – 6-10mm posterior tibial translation. A complete tear of PCL without another injury. Anterior tibia flush with femoral condyles....Grade III (complete PCL with combined capsular and/or Ligamentous injury) - > 10mm posterior tibial translation. Tibia posterior to femoral condyles which may indicate a concomitant capsuloligamentous injury....."
What determines the decision to reconstruct a torn posterior cruciate ligament?
Isolated grade I or II PCL injuries are generally treated without surgery.
However, when more severe tears occur together with other ligament or meniscus injury, then surgery is indicated.
"...Some studies have reported good outcomes after conservative treatment of partial PCL tears, while others have reported poor results at long-term follow-up with disabling symptoms and functional limitations...."
Surgical reconstruction of the PCL
The posterior cruciate ligament is comprised of two bundles.
The surgeon may decide on a 'single-bundle' reconstruction or may attempt to better restore the anatomy with a 'double-bundle' technique, using the hamstrings tendons harvested from the patient.
"....Anatomic single-bundle PCL reconstruction....typically restores the larger anterolateral bundle....and represents the most commonly performed procedure....."
Forum discussions
- "PCL/PLC etc.. reconstruction - Am I really volunteering for this?" - Patients discussing PLC and PCL issues.