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Like the Anterior cruciate ligament, the Posterior Cruciate ligament holds the responsibility of preventing a posterior subluxation/sag of the leg bone. This is also responsible for establishing a central stabilizer of the joint.
Posterior cruciate injuries usually result from a an anterior blow to the knee or the upper leg. This leads to a complete tear or avulsion of the bone piece where PCL is attached. The patient usually has acute swelling which settles down with ice packs, physiotherpay and medications. Later, the patient starts complaining of inability to squat and sit cross legged. Unlike ACL injury, PCL injury does not typically cause instability but patient primarily compliants of pain climbing downstairs and on deep flexion.
It is imperative to estabilish the central stabilizer of the knee joint. In cases where multi-ligament injury is suspected, it is imperaive to first reconstruct PCL followed by any other ligaments. Arthroscopic techniques have evolved the reconstruction procedure and excellent functional results have proven its credibility. The rehabilitation protocol for PCL reconstruction or multi-ligament reconstruction is quite different from post-ACL rehabilitation. Phase 1 usually takes about 4-6 weeks of non weight bearing and 4 weeks of no knee bending.
In phase 2, progressive knee bending of upto 90 is achieved and range of motion with full weight bearing is started. The patient is allowed to do swimming, cycling, stationary jogging by 3-4 months time and can start running and playing sports by 8-10 months of surgery depending on indivisual rehabilitation status.
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