PCL reconstruction

PCL (Posterior Cruciate Ligament) reconstruction is a surgery to replace a torn PCL, restoring knee stability using a tissue graft (from the patient or a donor) to create tunnels in the femur and tibia, fixating the graft, and often involving advanced arthroscopic techniques like double-bundle or inlay methods for anatomical repair, followed by extensive physiotherapy. This demanding procedure aims to restore natural knee movement, requiring significant rehabilitation for strength and proprioception, often taking 6-9 months to return to sports

The Procedure

  • Graft Harvesting: A tendon (from your patellar tendon, hamstring, or a donor) is prepared.
  • Tunnel Creation: The surgeon drills tunnels in the thigh bone (femur) and shin bone (tibia) at the PCL's original attachment points.
  • Graft Placement: The new tendon graft is passed through the tunnels.
  • Fixation: The graft is secured with screws or staples, often in specific knee flexions (e.g., 90 degrees for the anterolateral bundle) to mimic the original ligament.
  • Techniques: Common methods include single-bundle (focusing on the main part) or double-bundle (recreating both bundles) for better anatomy, and tibial inlay (minimally invasive).

Rehabilitation & Recovery

  • Immediate (Weeks 1-6): Crutches, a brace, and gentle range-of-motion exercises (limited flexion).
  • Early Strengthening (Weeks 6-12): Focus on quadriceps (open/closed chain), light cycling, and starting proprioception training.
  • Progressive Strengthening (Months 3-6): Increasing weights, squats (limited depth), light jogging, and more advanced balance exercises.
  • Return to Sport (6-9+ Months): Gradual introduction of pivoting, cutting, and contact sports after full strength and stability are achieved.

Key Considerations

  • Physiotherapy is Crucial: A dedicated commitment to rehab is essential for success.
  • Proprioception: Special attention is paid to balance training due to the PCL's role in sensing knee position.
  • Graft Type: The choice between allograft (donor) and autograft (your own tissue) impacts recovery and surgical approach.