PCL Tear: Complete, Partial, and Associated with Medial or Lateral Damage

Abstract

Posterior cruciate ligament (PCL) tears most commonly result from motor vehicle collisions or sports-related trauma. The most frequent mechanism of injury is a posteriorly directed blow to the anterior proximal tibia, often from a dashboard in automobile collisions, or due to impact with the ground when falling onto a flexed knee in sports. Multiligament knee injuries involving the PCL are much more common than isolated PCL tears. The work-up must always begin with a complete history and physical examination. A multitude of special tests have been described to assist in diagnosing PCL injuries and associated medial and lateral ligament damage. Following the history and physical examination, radiographs and magnetic resonance imaging (MRI) are often used to assist in the diagnosis. Stress radiographs have been shown to be particularly helpful with both the initial and follow-up diagnosis because of reliable reproducibility and objective assessment of posterior translation. Moreover, examination under anesthesia and arthroscopic evaluation are also critical in the work-up of PCL injuries. The diagnosis and classification of PCL tears is crucial to patient outcomes because the management of isolated PCL tears and combined multiligamentous injuries is often very different.