PCL reconstruction

POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION (PCL)

This information sheet provides information on the nature and purpose of the procedure in addition to an outline of the post-operative rehabilitation.

Purpose and description of the procedure

The PCL is the largest ligament in the knee and stops the shin bone (tibia) from moving too far backwards.

It is commonly injured by a blow to the front of the upper shin, such as during a fall onto the flexed knee. Hyperextension (over straightening) and hyperflexion (over bending too far) of the knee can also tear the PCL and it is often torn in high energy injuries dislocating the knee such as falling from a height or in RTA's. Not everyone who has a PCL injury will require surgery as milder or partial isolated tears (no other ligaments involved) can heal just with the aid of an appropriate brace and rehabilitation. When torn the problem symptom is a feeling of ‘looseness’ and a feeling of giving way.

Often a brace is recommended, holding the tibia forwards and controlling stability. This helps predict who would respond well to the operation. The knee can tolerate some looseness associated with a healed PCL ligament but it depends on the required sport and how the ligament heals.   

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Post-Op Posterior Cruciate Ligament bracing Protocol

  1. On day of surgery Lead Physio to measure patient and order Medi PCL dynamic brace
  2. At the end of operation patient is fitted with Medi PTS brace - PTS brace to be worn at all times including at night for the first 3 weeks - May remove brace for range of motion physio exercises and to wash leg
  3. At 3 weeks PTS brace to be changed to the Medi PCL dynamic brace as initial post-op swelling should have improved - Allow 0-90 degrees of flexion (this is the default setting of the PCL dynamic brace) - Wear PCL dynamic brace at all times including at night until 8 weeks
  4. At 6-8 weeks when reviewed in clinic remove the ‘90’ degree stop from the brace to allow full range of movement - Continue with dynamic brace at all times except physio exercises until 3 months post-op - May stop using brace at night after 3 months
  5. Continue dynamic brace when walking for 4-6 months post-op as decided by