What is the procedure for PCL reconstruction?
Management of PCL injury depends on the type of injury time passed since Injury and complaints of the patient. The PCL injury may be associated with bony avulsion from tibia or isolated PCL ligament tear, if there is no displacement of avulsed bony fragment of PCL or the tear is partial low-grade then it can be managed conservatively by brace and followed by physiotherapy. The surgical management of PCL can be done by open or arthroscopically reconstruction of torn ligament and repair or fixation of avulsed fracture fragment
How is the procedure done?
PCL reconstruction or repair can be done arthroscopy by keyhole incisions over the knee and viewing the joint inside by camera and scope. And reconstruction is done with tendon grafts taken from the patient’s own body harvested from hamstrings or quadriceps and prepared to shape it like ligament. It is then passed bone tunnel and placed at the site of the ligament and is fixed in the femur and tibia bone tunnel with the help of a button or screw. In case of PCL avulsion injury repair can be done by open or arthroscopy means in which fixation is done with screw in open surgery. In arthroscopic surgery it is done by taking bites in PCL near the bony avulsion and pulling it down by that suture through the bone tunnel and fixation over button on tibia.
How does recovery happen?
PCL injuries usually recover in 7-9 months. In low grade partial tear or un-displaced avulsion fracture the management is conservative by brace for 4 weeks followed by weight bearing, active and passive ROM of knee joint. Returning to sports or heavy activities after months depends on stability. In surgical management the patient needs to use a brace and walker for 4-6 weeks’ time followed by knee static exercises. Patients are allowed to bear weight from 3 – 4 weeks with knee range of motion on knee. After 6 weeks the patient will walk without any support depending on exercises and recovery of the patient. Return to sports activities is usually 8 months post-surgery.
What should you expect from the procedure?
Post PCL reconstruction one should expect strength and stability of knee, progression of knee exercises, return to activities will be early.
Why is this procedure done?
PCL reconstruction is advised to gain knee stability, regain functional capability, prevent further damage to knee; injury to other structures like meniscus and cartilage and development of arthritis.