Injuries to the posterior cruciate ligament (PCL) are rare, accounting for only about 5% of all knee ligament injuries. There is disagreement among physicians over which patients with isolated PCL ruptures (that do not have any other ligament damage) should have surgery and which patients should not have surgery – and for those who need surgery, just how to perform it to achieve the best results. The problem is that these injuries can either not cause many problems, or they can be disabling and cause considerable problems with sports and, in some cases, regular activities of daily living.

Physicians and researchers at Cincinnati Sportsmedicine have lead research efforts in the diagnosis and treatment of PCL injuries for over 20 years. The combination of our laboratory and clinical studies have influenced the manner in which physicians now treat patients with these injuries.

“What makes treatment of patients with PCL injuries so difficult is that many factors must be considered. These include if other ligaments in the knee are also damaged (which is often the case), if arthritis is already present, and how much time has gone by since the injury. While studies on ACL injuries involve hundreds of patients, allowing us to make treatment recommendations based on sound data, studies on PCL injuries involve only a few patients. This is why it has taken so long to advance our knowledge of how to properly treat patients with this injury, and why so much controversy continues to exist on whether surgery or a conservative approach is the best option. There are few sports medicine centers in the country that have devoted two decades of research effort concerning PCL injuries. We provide treatment recommendations based on both research and clinical experience – a rare combination for a rare injury.” 

Sue Barber-Westin
Director of Clinical Research Studies
Noyes Knee Institute

“We believe that young active patients who sustain a complete tear to the PCL should be seriously considered for an early reconstruction of the ligament to avoid arthritis which may develop some years in the future. Unfortunately, many patients who injured their PCL a long time ago often develop arthritis and then seek care when it is too late. The goal of treatment in these patients is usually to provide pain-free activities of daily living, which may or may not include surgery. We were the first in the country to develop a very active rehabilitation program after PCL reconstruction, which includes immediately moving the knee and performing exercises which have resulted in one of the lowest complication rates reported in the medical literature. That’s good news for the patients who require surgery. PCL surgery is still developing and newer techniques are being developed every year.”

Frank Noyes, M.D.
President 
and Medical Director
Noyes Knee Institute
Cincinnati SportsMedicine & Orthopaedic Center