Posterior Cruciate Ligament: Injury, Diagnosis, and Management

Posterior cruciate ligament (PCL) injuries represent a minority of isolated ligamentous injuries to the knee. However the sequelae of these injuries can have a significant negative impact on function leading to instability, pain, and arthritis. A thorough understanding of the anatomy, mechanism of injury, and, pathophysiological changes that can occur with impaired PCL function can help the clinician formulate a specific treatment algorithm.Up to this point, there has been no consensus on optimal treatment for these injuries. The vast majority of isolated PCL injuries are treated conservatively including grade I, grade II, and even some grade III tears. However, a myriad of operative options exist in grade III tears and concomitant knee ligamentous injuries. These include single-bundle (SB), doublebundle (DB), tibial inlay, and anteriomedial or anteriolateraltranstibial reconstruction techniques. This review will provide an introduction to PCL injuries, how they are diagnosed both on physical examination and on imaging studies, and how best to treat these injuries. The authors’ preferred algorithm for conservative versus operative treatments is also presented. Review Article