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PCL injury should I ask about surgery?

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October 15th, 2011
5 months ago I broke my tibia by running into a jetski trailer. I was in a full cast for 2 months and then a cast up to my knee for another month. 1 more month walking with crutches. Then I started physical therapy a month ago to regain strength in my quad/knee ect. So far I feel the muscles are stronger then they were but still have pain in the knee. Now the doctor thinks the accident damaged my PCL as well and I am getting an MRI to confirm. He said the treatment for it would be physical therapy, but I have been doing that for a month and the knee pain hasnt changed. If the MRI comes back showing the PCL completely torn, should I ask about surgery? If not, how long do I continue doing physical therapy before considering surgery if the knee pain continues?
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Gaelic
replied October 17th, 2011
Especially eHealthy
jtown2257,

Not all PCL injuries need to be fixed. As opposed to the ACL, which usually causes functional instability, the PCL usually does not.

The usual treatment is to have the patient do PCL specific therapy. If the patient does not have instability symptoms, then a reconstruction is not needed.


Unfortunately, unless it can be determined that the pain is actually being caused by the PCL instability, then a reconstruction would most likely not take the pain away, and may even make it worse.

Usually, instability, or the giving away of the joint with certain movements, does not cause pain. The the case of the PCL, the patient just ends up on the ground when trying to stop suddenly. But, again, this is kind of rare, as most patients do not develop PCL instability.


So, if the MRI does show a complete PCL rupture, then usually the surgeon will start you in PCL specific sports therapy. If, on the rare chance it turns out that you do develop instability, then a reconstruction is warranted. But, the reconstruction in for instability, not pain.

If it is just pain that is bothering you, then the cause of the pain has to be determined. Do you have a torn meniscus or a defect in the articular cartilage? Whatever the etiology, that's the thing that needs to be addressed.


Wishing you the best. Good luck.
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