When Do You Need to Reconstruct the Posterior Cruciate Ligament

Posterior Cruciate Ligament (PCL) injuries are most commonly caused by traffic accidents and sporting injuries. Most are appropriately managed non-operatively. The goal of surgical treatment is to restore stability to the knee and reduce the risk of osteoarthritis caused by abnormal knee kinematics. Accurate clinical assessment is essential as the radiological grade of injury on MRI does not correspond to the clinical grade. Grade I PCL injuries can be managed non-operatively. Isolated Grade II PCL injuries are usually managed in a dynamic PCL brace. Grade III PCL injuries require a PCL repair or reconstruction. It is important to exclude other ligamentous injuries as part of the assessment. Most surgeries for the PCL are undertaken in the setting of a combined ligament injury. Although the results of PCL surgery are not as predictable as those for ACL surgery, a return to play can be expected in most athletes.