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Arthroscopic PCL Reconstruction

Dr. Lingaraju A P - Consultant Orthopaedic & Joint Replacement

What is PCL?

The posterior cruciate ligament (PCL) is the main stabilizing ligament on the inside of the knee. Its main function is to prevent the tibia (shin bone) from sliding backward and rotating on the femur (thigh bone). Tears/ruptures of the ligament result in knee instability. PCL tears are less common than ACL.

What are the causes?

PCL tears are typically caused by trauma or a fall on the knee. A direct posterior/backward force on the tibia commonly seen in collision sports or the knee hitting the dashboard in a motor vehicle accident will cause a PCL tear.

What are the symptoms?

PCL tears cause immediate pain and often swelling. You may feel something “pop” inside the knee. An initial inability to bear weight on the leg may subside and walking may be possible after several minutes. The knee may feel loose or that it is going to “give out” and immediate return to sport is impossible. Over time, swelling will increase and motion may be lost. Unlike ACL tears, some patients, even athletes, can return to sport with partial PCL tears and never require surgery. Your activity level decides surgical intervention but not the age.

What are the types of PCL graft?

1. Hamstring tendon graft:-The semitendinosus hamstring tendon on the inner side of the knee is commonly used.
2. Allograft (taken from a cadaver) patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon

How PCL tear repaired?

Usually done under spinal anaesthesia. Surgeon makes two small key holes in front of the knee to insert arthroscope into the joint. At first complete visualisation of knee joint done. Meniscus and cartilage injuries repaired. The graft harvested and prepared. The bone tunnels are drilled into the tibia and the femur to place the PCL graft in place of the original ligament. The graft is placed in the tunnels and fixed with biodegradable interference screws or anchors. The entire surgery performed through a minimally-invasive arthroscopic procedure and all inside technique.

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