A blow to the front of the knee, often seen in car accidents when the knee hits the dashboard, can push the shinbone backwards, straining or tearing the PCL.
Posterior Cruciate Ligament (PCL) Injury Specialist In Singapore
Dr Wang Lushun
Senior Consultant Orthopaedic Surgeon
MBBS (Singapore)
MRCS (Edin)
MMed (Ortho)
FRCS (Ortho) (Edin)
- Fellowship-trained orthopedic surgeon
- Internationally recognised, more than 1500 surgeries performed
What is a PCL Injury?
A posterior cruciate ligament (PCL) injury involves damage to one of the main ligaments located in the back of the knee. The PCL helps stabilise the knee by preventing the shinbone from moving too far backwards relative to the thighbone. These injuries typically occur due to direct impact on the front of the knee or when the knee bends too far backwards, such as in car accidents or during sports. The severity of PCL injuries ranges from a minor sprain to a complete tear, impacting knee stability and movement.
Symptoms of PCL Injury
The most common symptoms of a PCL injury include:
Pain at the Back or Front of the Knee
Pain occurs due to the overstretching or tearing of the ligament, leading to inflammation and irritation in the area behind the knee. It may worsen with knee movement or weight-bearing activities.
Swelling
Inflammation in response to ligament damage causes fluid buildup around the knee joint, resulting in visible swelling.
Knee Instability
Instability occurs because the torn or weakened ligament cannot properly stabilise the knee, causing the joint to feel like it will give way, particularly during physical activity or when carrying weight.
Reduced Range of Motion
Swelling and inflammation can restrict movement, causing stiffness and making it difficult to fully bend or straighten the knee.
Causes of PCL Injury
PCL injuries are typically caused by events that place excessive force on the knee, particularly from:
Direct Impact
Sports Injuries
High-impact sports such as soccer, skiing, or rugby can involve sudden movements such as quick changes in direction, abrupt stops, or direct collisions. These movements can overstretch and damage the PCL.
Falls
Falling directly onto a bent knee drives the shinbone backwards, leading to a PCL injury. Activities with a higher risk of falls, such as gymnastics or skateboarding, are more likely to cause these injuries.
Knee Dislocations
Severe trauma that causes a knee dislocation, where the bones of the knee joint are forced out of alignment, often leading to PCL tears.
Types of PCL Injuries
PCL injuries are classified based on the severity of the ligament damage. These classifications help guide the appropriate treatment approach.
Grade 1: Mild
The PCL is overstretched but remains intact, with minimal damage to the ligament fibres. While the knee retains overall stability, the injury may still affect performance during physical activities.
Grade 2: Moderate
This involves a partial tear of the PCL, where some ligament fibres are damaged. The knee may feel less stable than usual, especially during weight-bearing activities or sudden movements.
Grade 3: Severe
A complete tear occurs when the PCL is fully ruptured, resulting in significant instability, pain and swelling. This type of injury can impair the knee’s ability to support weight or function properly, often requiring surgical reconstruction.
Diagnosis of PCL Injury
Diagnosing a PCL injury involves several methods to determine the extent of damage and plan the appropriate treatment.
- Physical Examination: The doctor examines the knee for tenderness and swelling. They apply pressure to the joint and test knee movement to evaluate stability and identify signs of ligament damage.
- Imaging Tests: X-rays help rule out bone fractures and joint dislocations. An MRI scan provides detailed images of the soft tissues, including the PCL, to determine the extent of the ligament tear, whether it is partial or complete, and detect any additional injuries.
- Joint Testing: Specific physical tests, such as the posterior drawer test (in which the doctor pushes the shinbone backward with the knee bent at 90 degrees), are used to confirm PCL damage.
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Treatment Options for PCL Injury
The approach to treating a PCL injury varies based on its severity, ranging from conservative non-surgical methods to surgical intervention.
Non-Surgical Treatment
Rest, Ice, Compression, and Elevation (RICE)
RICE helps reduce pain and swelling in the injured knee by limiting movement, reducing inflammation, and promoting healing. Rest allows the ligament to recover, while ice and compression control swelling. Elevation helps fluid drain away from the injury site.
Knee Bracing
A knee brace stabilises the joint, preventing further damage to the PCL by limiting knee motion. This gives the ligament time to heal while supporting the surrounding muscles.
Physical Therapy
Physical therapy focuses on exercises that strengthen muscles surrounding the knee, particularly the quadriceps and hamstrings, which support stability. It also helps restore range of motion and flexibility, reducing the risk of re-injury.
Surgical Treatment
Surgery is typically recommended for severe (Grade 3) PCL injuries where the ligament is fully torn.
Ligament Repair
Ligament repair may be indicated for acute bony avulsions of the PCL. This approach preserves the ligament’s natural structure, promoting proper healing and restoring knee stability.
Ligament Reconstruction
When the ligament is extensively damaged and nonfunctional, reconstruction may be required. This involves replacing the damaged ligament with a tissue graft from the patient’s own body (autograft) or a donor (allograft). The graft restores the ligament’s function and stability.
Prevention and Management of PCL Injury
Preventing PCL injuries involves strengthening the quadriceps and hamstrings to stabilise the knee, improving balance and coordination to reduce the risk of sudden movements, and using knee braces for added support during high-risk activities. Adopting proper movement techniques and warming up before exercise also help minimise strain on the ligament.
For those recovering from a PCL injury, following a structured rehabilitation plan ensures proper healing and prevents re-injury.
Dr Wang Lushun
Senior Consultant Orthopaedic Surgeon
MBBS (Singapore)
MRCS (Edin)
MMed (Ortho)
FRCS (Ortho) (Edin)
Internationally Recognised & Double Fellowship-Trained Surgeon With Over 18 Years of Experience
- Bachelor of Medicine & Bachelor of Surgery (MBBS),
National University of Singapore - Member of The Royal College of Surgeons (MRCS),
Edinburgh, United Kingdom - Master of Medicine in Orthopaedic Surgery (MMed),
National University of Singapore - Fellow of The Royal College of Surgeons in Orthopaedics and Traumatology (FRCS), Edinburgh, United Kingdom
As a Senior Consultant Orthopaedic Surgeon and former Head of the Hip and Knee Division in Ng Teng Fong Hospital, he has won awards for superior patient outcomes (value driven), service quality and enhanced recovery programmes. His patients include current and former national athletes and sporting professionals.
Why Choose
Dr Wang Lushun?
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
Can I Use Medisave For My Treatment?
Yes, you can use funds from your Medisave account to offset the cost of your treatment.
Reach out to us today to learn more about payment options.
Patient-Centred Orthopaedic Care
We are dedicated to your recovery and well-being. Every patient deserves the freedom that comes with active living. Whether you're an athlete sidelined by an injury or a weekend hobbyist desperate to return to your passion, our mission is to help you regain your mobility and independence.
Personalised Approach For Positive Outcomes
Our clinic prioritizes time dedicated to understanding each patient’s injuries and needs. Dr Wang strongly believes that personalised care & patient management will lead to better outcomes & positive experiences.
Minimally Invasive Techniques For Faster Recovery
Dr Wang’s extensive experience with minimally invasive procedures allows for less scarring, lower risk of complications and faster recovery compared to traditional surgical methods.
Aftercare Focused On Restoring Mobility & Well-Being
As an avid sportsperson, Dr Wang understands the time and patience required to regain mobility and return to active living. After your procedure is completed, Dr Wang will make sure your recovery is smooth and comfortable.
Insurance
We accept all patients, with or without insurance plans. Additionally, we are on the specialist panels of these Health Networks/Insurance Plans. Please contact us if you have any queries and we will be happy to assist you in checking with your insurance provider.
Our Clinic Locations
3 Mount Elizabeth, #13-14
Mount Elizabeth Medical Centre
Singapore 228510
820 Thomson Road, Mount Alvernia Hospital, #05-51, Medical Centre D, Singapore 574623
Frequently Asked Questions (FAQs)
How can I tell if my PCL injury requires surgery?
Surgery is usually required for severe (Grade 3) injuries when the PCL is completely torn, causing significant knee instability. A consultation with a specialist and imaging tests (MRI) can confirm whether surgery is needed.
How long is the recovery after PCL surgery?
Recovery after PCL surgery typically takes 6 to 12 months, depending on the extent of the injury. It usually involves a structured rehabilitation programme to restore strength and mobility. Athletes or individuals in physically demanding activities may take longer to return to their previous activity level.
Is a torn PCL more severe than an ACL injury?
While both injuries compromise knee stability, PCL injuries are generally less common and may cause less immediate instability compared to ACL injuries. However, untreated PCL injuries can lead to long-term knee instability and arthritis.