Management of PCL Injuries in Handball

Abstract

Posterior cruciate ligament (PCL) injuries are rare injuries in sports compared with other acute knee ligament injuries such as medial collateral ligament (MCL) and anterior cruciate ligament (ACL) injuries. The major function of the PCL is to provide a restraint to posterior displacement of the tibia on the femur. There are three dominating injury mechanisms described: hyperextension, hyperflexion and pretibial contact with a flexed knee such as in the dashboard injury or in a fall on the knee with a plantarflexed foot. It is paramount to distinguish early after the incident if the PCL injury is isolated or combined with other significant knee injuries. The most common treatment for an isolated PCL injury is a non-surgical protocol with bracing and stepwise rehabilitation. Return to handball and other similar knee-demanding sports can usually be expected within 5 months after such treatment. No firm conclusions can be drawn about the outcome and return to play rate after PCL reconstruction in handball players. All in all, the literature on PCL injuries is scarce compared with that on ACL injuries, and further studies on treatment and prevention are highly warranted.