Posterior cruciate ligament (PCL) reconstruction

Posterior cruciate ligament reconstruction is an operation to replace your torn Posterior Cruciate Ligament (PCL) and restore stability to your knee joint.

The PCL is the largest ligament in the knee and stops the shin bone from moving too far backwards. It is commonly injured by a blow to the front of the upper shin. Most athletic PCL injuries occur during a fall onto the flexed knee. Hyperextension (‘over straightening’) and hyperflexion (‘bending too far’) of the knee can also cause a PCL injury and the PCL is often involved when there is injury to multiple ligaments in a knee dislocation. Not everyone who has a PCL injury will require surgery as some isolated tears (no other ligaments involved) can heal just with the aid of an appropriate brace. If the initial diagnosis is not appreciated or the ligament does not heal, some people will notice ‘looseness’ and an occasional feeling of giving way. This requires a reconstruction (replacement) operation.

The operation The operation is done with the aid of the arthroscope (keyhole surgery). The most commonly used graft is made up of two of your own hamstring tendons - taken from the same leg. A tiny incision is made over the upper inner part of the shin and the hamstring tendons are collected and folded over to form a four strand graft. This is then passed through the knee and securely fixed matching the original position of the ruptured ligament. A brace is fitted at the end of the procedure which helps to protect the graft in the early weeks of recovery.

Outpatient physiotherapy This usually starts within the first week following surgery. We follow established protocols to gain best outcomes to allow the patient to return back to their earlier activities at the earliest. Duration to return to sports may take 6-9 months.